Incidence of anemia development among diabetic and

non-diabetic individuals in a tertiary care center

Guided by:
Dr. V.Lokeshwari
AIM:
 The aim of the study is to evaluate the
occurrence of anemia in diabetic and non-
diabetic patients.
 Assess the complications with respect to age,
gender, hematological and other biochemical
parameters.
To aid early diagnosis by regular health checkups
and to educate them for life style modification.
INTRODUCTION:
Diabetes Mellitus (DM) has become the major public
health concern globally and it is defined as metabolic
cum vascular syndrome of multiple etiology
characterized by chronic hyperglycemia with
disturbances of carbohydrate, fat and protein
metabolism resulting from defects in insulin
secretion, insulin action our both leading to changes
in both small blood vessels (microangiopathy) and
large blood vessels (macroangiopathy).
• Anemia is more common in Type 2
Diabetes Mellitus (T2DM) which often
goes unrecognized, despite its
contribution to the morbidity and
mortality. Thus the burden of diabetes
magnifies its prevalence. The reported
prevalence of T2DM associated anemia
ranges from 11% to 55% which is related
to various parameters.
 Various studies suggest that anemia
related renal complications are more
common in diabetic individuals as it
develops earlier than in non diabetic
individuals. Anemia is more common in
type 2 DM which often goes
unrecognized, despite its contribution to
the morbidity and mortality.
 Majority of the T2DM patients with
anemia have normocytic anemia, which
is consistent with anemia of chronic
disease. Obesity has been associate with
release of cytokines and hepcidin, which
may impair iron utilization, increasing
risk of anemia. DM is also noted in non-
obese individuals.
 Many factors have been suggested to contribute
in the pathogenesis of anemia in these patients,
such as erythropoietin deficiency due to efferent
sympathetic denervation of the kidney in the
context of diabetic neuropathy, chronic
inflammatory reaction leading to functional iron
deficiency, non selective urinary protein excretion
leading to transferrin and erythropoietin loss and
the use of RAAS blockers which are central in the
treatment of proteinuric diabetic nephropathy.
MATERIALS AND METHODS:
• This is a case-control study involving 100 known T2DM
individuals and 100 non-diabetic individuals with renal
insufficiency within 30 –60years of age, which will be
proceeded after the approval by the Ethical committee in our
institution to assess the risk and its complications in a
tertiary care center for a period of 2 months.
• The following parameters are included in the study:
age,sex, glycemic profile, duration of the condition,
treatment history for DM, hemogram, urea, creatinine,
albumin:creatinine ratio, BMI- height and weight, lifestyle,
family history and co morbidities.
• Patients were categorized as anemic according to WHO
criteria(Hb <12 gram/dl for females and Hb <13 gram/dl
for males) and other parameters with its standard values.
• The diagnostic criteria by American Diabetes Association
(ADA) include the following standard range to diagnose
DM: fating plasma glucose level of 126 mg/dl or higher,
2-hour plasma glucose level of 200mg/dl.
• Type 1 diabetes mellitus patients are excluded in this
study.
IMPLICATIONS:
This study concludes that anemia is most
commonly associated with type 2 diabetic
patients even with normal renal parameters.
The main advantage of this study is to
diagnose anemia and other complications
earlier in both diabetic and non diabetic
individuals and to create awareness, educate
them about the condition for better lifestyle.
REFERENCES:
• 1. Charalampos Loutradis, Alexandra Skodra, Panagiotis Georgianos, Panagiota
Tolika, Dimitris Alexandrou,Afroditi Avdelidou, Pantelis A Sarafidis. Diabetes
mellitus increases the prevalence of anemia in patients with chronic kidney disease:
A nested case-control study. 2016 July 6; 5(4): 358-366.
• 2. Jéssica Barbieri,1 Paula Caitano Fontela,2 ElianeRoseli Winkelmann,3,4Carine
Eloise Prestes Zimmermann,5, et al. Anemia in Patients with Type 2 Diabetes
Mellitus. Received 30 June 2015; Revised 7 September 2015; Accepted 13
September 2015.
• 3. Oyindamola Ibukun Awofisoye, Jokotade Oluremilekun Adeleye1, John Ayodele
Olaniyi2, Arinola Esan3. Prevalence and correlates of anemia in type.
• 2 diabetes mellitus: A study of a Nigerian outpatient diabetic population January
22, 2020, IP: 106.198.34.23.
• 4. Salman MA (2015) Anemia in Patients with Diabetes Mellitus: Prevalence and
Progression. General Med 3: 1000162. doi:
10.4172/2327-5146.1000162.