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Anemia And Diabetes Type 2

Anemia In Patients With Type 2 Diabetes Mellitus

Anemia In Patients With Type 2 Diabetes Mellitus

Anemia in Patients with Type 2 Diabetes Mellitus Jssica Barbieri,1Paula Caitano Fontela,2Eliane Roseli Winkelmann,3,4 Carine Eloise Prestes Zimmermann,5,6 Yana Picinin Sandri,4,6 Emanelle Kerber Viera Mallet,6and Matias Nunes Frizzo3,6 1Regional University of Northwestern Rio Grande do Sul (UNIJU 2Program in Respiratory Sciences, the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil 3Department of Life Sciences, the Regional University of Northwestern Rio Grande do Sul (UNIJU 4Program in Integral Attention to Health (PPGAIS-UNIJUI/UNICRUZ), Iju 5Program in Pharmacology of the Health Sciences Center, e Federal University of Santa Maria (UFSM), RS, Brazil 6Cenecista Institute for Higher Education, Rua Dr. Jo ao Augusto Rodrigues 471, 98801 015 Santo Correspondence should be addressed to Carine Eloise Prestes Zimmermann; carine [email protected] and Matias Nunes Frizzo; [email protected] Received June ; Revised September ; Accepted September essica Barbieri et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. e objective of this study was to evaluate the prevalence of anemia in DM patients and its correlation with demographic and lifestyle and laboratory variables. is is a descriptive and analytical study of the type of case studies in the urban area of the city, registered in programs of the Family Health Strategy, with a total sample of patients with DM. A semistructured questionnaire with sociodemographic and clinical variables and performed biochemical test was applied. Of the DM patients studied, patients had anemia, and it was found that the body mass items and hyper Continue reading >>

Anemia In Patients With Type 2 Diabetes Mellitus

Anemia In Patients With Type 2 Diabetes Mellitus

1Regional University of Northwestern Rio Grande do Sul (UNIJUÍ), Ijuí, RS, Brazil 2Program in Respiratory Sciences, the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil 3Department of Life Sciences, the Regional University of Northwestern Rio Grande do Sul (UNIJUÍ), Rua do Comércio No. 3000, Bairro Universitário, 98700 000 Ijuí, RS, Brazil 4Program in Integral Attention to Health (PPGAIS-UNIJUI/UNICRUZ), Ijuí, RS, Brazil 5Program in Pharmacology of the Health Sciences Center, The Federal University of Santa Maria (UFSM), RS, Brazil 6Cenecista Institute for Higher Education, Rua Dr. João Augusto Rodrigues 471, 98801 015 Santo Ângelo, RS, Brazil Academic Editor: Eitan Fibach Copyright © 2015 Jéssica Barbieri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The objective of this study was to evaluate the prevalence of anemia in DM2 patients and its correlation with demographic and lifestyle and laboratory variables. This is a descriptive and analytical study of the type of case studies in the urban area of the Ijuí city, registered in programs of the Family Health Strategy, with a total sample of 146 patients with DM2. A semistructured questionnaire with sociodemographic and clinical variables and performed biochemical test was applied. Of the DM2 patients studied, 50 patients had anemia, and it was found that the body mass items and hypertension and hematological variables are significantly associated with anemia of chronic disease. So, the prevalence of anemia is high in patients with DM2. The set of observed changes characterizes the anemia of chronic dis Continue reading >>

Anemia And Much Older Type 2 Diabetes Patients

Anemia And Much Older Type 2 Diabetes Patients

Home / Conditions / Type 2 Diabetes / Anemia and Much Older Type 2 Diabetes Patients Anemia and Much Older Type 2 Diabetes Patients Anemia is higher in older type 2 diabetes patients The chances of an anemia diagnosis increase with age and it affects roughly about 10% of those 65 years of age or older. In diabetes patients, the probability of diagnosing anemia could be two to threefold higher and furthermore, from previous studies, anemia has been shown to have a direct relationship with renal insufficiency. There are many factors that can lead to increasing the probability of getting anemia including decreasing renal function, inflammation, bone marrow suppression, and nutritional deficiencies. In this study, the researchers examined the prevalence and determinants of anemia among people age 85 years or older with a long duration of diabetes. A total of 115 patients, average age 83.6 years old with 51% older than 85 years of age, were recruited for this study. About 50% of patients were male and ethnicity was 108 White, 5 Asian, and 2 Black. Anemia was prevalent in 59% of the older patients (>75 years of age) diagnosed as diabetes outpatients. The 80% of anemia was normocytic; anemia was microcytic in 17%, and macrocytic in 3% of patients. Patients with anemia were significantly older (84.6 vs. 82.1 years, P = 0.01), had a longer duration of diabetes (17.7 vs. 13.5 years, P = 0.03), and had lower eGFRs (47.8 vs. 58.1ml/min/1.73 m2, P = 0.01) than patients without anemia. In the univariate logistic regression analysis, three of the five potential determinants significantly predicted anemia: older age 85 years (OR 4.8, 95% CI 2.17.8, P = 0.001), longer duration of diabetes > 15 years (OR 2.9, 95% CI 1.3to 6.2, P = 0.01), and CKD (OR 3.4, 95% CI 1.57.6, P = 0.002), where Continue reading >>

Iron: How This Supplement Could Impact Your A1c

Iron: How This Supplement Could Impact Your A1c

We need iron. Without enough iron, we’ll get sick. But too much iron can kill us. As with so many things relating to our health, it’s a balancing act. Most people who eat meat get sufficient iron. Some foods these days are also supplemented with iron. The chocolate syrup Bosco was designed to get children to consume more iron. Cooking in iron pots, especially cooking acid foods, adds iron to our diet. Multivitamins designed for younger people contain iron (especially those for pregnant women, as the fetus consumes a lot of iron). Hence nonpregnant Western people who aren’t vegetarians usually get enough iron from their diet. People in Third World countries who don’t get much meat, however, are often iron deficient. Heme iron, or the iron that is in hemoglobin, the oxygen-carrying molecule in red blood cells, is absorbed even more efficiently than the nonheme iron that you get when you eat vegetables or take an iron-containing multivitamin pill. So eating meat, especially red meat and liver, should ensure that you get enough iron. Vitamin C will increase the absorption of iron, and large amounts of calcium or whole grains will decrease it. Those of us over 60 probably remember all those ads for “tired blood” in the 1950s and 1960s that implied that older people were tired because they didn’t have enough iron and needed to supplement with Geritol. So should we all try to get as much iron as possible? Nope. There is some evidence that high iron levels contribute to heart disease, and most “senior vitamins,” designed for people who are at an age at which heart disease is more likely, don’t have any added iron. Some people think that losing blood every month helps to protect younger women from heart disease. This protection is lost after menopause. Iron l Continue reading >>

Anemia Complicating Type 2 Diabetes: Prevalence, Risk Factors And Prognosis

Anemia Complicating Type 2 Diabetes: Prevalence, Risk Factors And Prognosis

Volume 31, Issue 7 , July 2017, Pages 1169-1174 Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes. Data from the Fremantle Diabetes Study Phase II (FDS2; n=1551, mean age 65.7years, 51.9% males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2years, 50.0% males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin 130g/L males, 120g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modeling identified predictors of death during 4.31.2years post-recruitment. The prevalence of anemia at baseline was 11.5% in FDS2 participants, 17.8% in BDS type 2 patients and 5.4% in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6%) had at least one other risk factor (serum vitamin B12<140pmol/L, serum ferritin <30g/L and/or transferrin saturation<20%, serum testosterone <10nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60mL/min 1.73m2, malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7% versus 8.0%; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, marital status, smoking, eGFR), anemia was associated with a 57% increase in mortality (P=0.015). Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors. Continue reading >>

Anemia And Diabetes: What's The Connection And How Do I Manage It?

Anemia And Diabetes: What's The Connection And How Do I Manage It?

Of course, these are also symptoms of a variety of other conditions, ranging from heart attack to hangover! So how can you tell if your symptoms are being caused by anemia? Firstly, let me explain what anemia is, and how diabetes, or more strictly speaking kidney disease, can cause it. When diabetes affects your kidneys (known as diabetic nephropathy), they may not be able to produce enough erythropoietin, a hormone that controls the production of red blood cells. With anemia there are fewer red blood cells than normal. Red blood cells carry oxygen to your bodys cells so if there are fewer healthy red blood cells, there is less oxygen being transported. The lack of oxygen may be causing the symptoms listed above. Normally when you develop anemia your body tries to correct the situation by producing more erythropoietin, but with diabetic nephropathy as part of the equation this might not be possible, as your kidneys might not be able to do this efficiently. Anemia can also be caused by certain medications used to treat diabetes and related conditions. Thiazolidinediones as well as metformin (Glucophage) can increase the risk of developing anemia. In particular, metformin may interfere with vitamin B12 absorption, and some doctors advise diabetics taking this medication to take a multivitamin as well. So why do you need to worry about developing anemia? Well studies show that diabetics with anemia are more likely to develop eye disease and suffer a heart attack or stroke. It sounds grim, but luckily its very simple to find out if you have anemia and to treat it. Its time to visit the vampire your doctor will be able to arrange blood tests to check if you are anemic, and how low your red blood cell count is. Your healthcare provider should arrange a complete blood count l Continue reading >>

Anemia, Diabetes, And Chronic Kidney Disease

Anemia, Diabetes, And Chronic Kidney Disease

Anemia, Diabetes, and Chronic Kidney Disease From the Department of Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas. Corresponding author: Robert D. Toto, [email protected] . Received 2008 Apr 23; Accepted 2009 Apr 14. Copyright 2009 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. This article has been cited by other articles in PMC. Diabetes is the leading cause of chronic kidney disease (CKD) and is associated with excessive cardiovascular morbidity and mortality ( 1 , 2 ). Anemia is common among those with diabetes and CKD and greatly contributes to patient outcomes ( 3 , 4 ). Observational studies indicate that low Hb levels in such patients may increase risk for progression of kidney disease and cardiovascular morbidity and mortality ( 5 ). Controlled clinical trials of anemia treatment with erythropoietin stimulating agents (ESAs) demonstrated improved quality of life (QOL) but have not demonstrated improved outcomes ( 6 10 ). In some trials, ESA treatment for high Hb levels is associated with worse outcomes such as increased thrombosis risk ( 6 , 11 ). Consequently, the U.S. Food and Drug Administration (FDA) and the National Kidney Foundation (NKF) have modified their recommendations regarding anemia treatment for CKD patients ( 12 ). The objectives of this review are to 1) update clinicians on the prevalence, causes, and clinical consequences of anemia; 2) discuss the benefits and risks of treatment; and 3) provide insight into anemia management based on clinical trial evidence in patients with diabetes and kidney disease who are not on dialysis. DEFINITION AND PREVALENCE OF A Continue reading >>

Diabetes And Anemia

Diabetes And Anemia

If you have diabetes, you’ll need to have your blood checked regularly for anemia. It’s common for people with diabetes to also end up with this blood condition. It happens when your body’s red blood cells can’t deliver as much oxygen as your body needs. If you spot anemia early on, you can better manage the issues causing it. Usually, it happens because you don’t have enough red blood cells. That can make you more likely to get certain diabetes complications, like eye and nerve damage. And it can worsen kidney, heart, and artery disease, which are more common in people with diabetes. Diabetes often leads to kidney damage, and failing kidneys can cause anemia. Healthy kidneys know when your body needs new red blood cells. They release a hormone called erythropoietin (EPO), which signals your bone marrow to make more. Damaged kidneys don’t send out enough EPO to keep up with your needs. Often, people don’t realize they have kidney disease until it’s very far along. But if you test positive for anemia, it can be an early sign of a problem with your kidneys. People with diabetes are more likely to have inflamed blood vessels. This can keep bone marrow from getting the signal they need to make more red blood cells. And some medications used to treat diabetes can drop your levels of the protein hemoglobin, which you need to carry oxygen through your blood. These drugs include ACE inhibitors, fibrates, metformin, and thiazolidinediones. If you take one of these, talk to your doctor about your risk for anemia. If you have kidney dialysis, you may have blood loss, and that can also cause anemia. When your brain and other organs don’t get enough oxygen, you feel tired and weak. Other signs you may have anemia include: Shortness of breath Dizziness Headache Pale Continue reading >>

Anemia And Diabetes | Diabetic Connect

Anemia And Diabetes | Diabetic Connect

Has anyone ever had the problem of being anemic and also being a diabetic? I found out yesterday that I am evidently anemic or am still anemic as I was anemic back in the winter and early Spring and was taking iron but the script ran out and I was overdue for blood work but now the results are back and I am evidently anemic. As of right now I am supposed to call the Dr. office as soon as I can and I don't have a clue as to what they will tell me about this but I figure I will be going back on iron again. My Dad is going through this right now. T2 diabetic for about 35 years. After several tests, they determined he has four stomach ulcers and are treating to heal those ulcers. The blood loss was causing the anemia. They are also testing to see if he has some type of bacteria in his stomach that may be causing or contributing to the ulcers, but most likely it's because he takes a full strength aspirin everyday (for years) for his heart condition. They are not taking away the aspirin, but adding a prescription strength antacid to coat the stomach. I hope they get your situation figured out soon. Good luck. Yes, I've been anemic and I have diabetes. My doctor had told me I was so severely anemic that I need a blood transfusion. I did have the blood transfusion, they administered 2 pints of whole blood to me. I became anemic do to stomach issues (UC) and I was losing quite alot of blood. I'm now checked every 6 months to see how I'm doing. They did not put me on iron pills. Continue reading >>

Metformin And Anemia?

Metformin And Anemia?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Does anyone knows if Metformin can cause anemia? I am so tired and keep getting chest infections Does anyone knows if Metformin can cause anemia? I am so tired and keep getting chest infections I've been on it for 11 years now and not so far. It's also more common in diabetics to have hypothyroidism. Go and get checked, including Ferritin, Hb and vitamin D. @CDudley - Metformin does not cause Aneamia, already challenged my GP about this, but it can cause B12 deficiency as the previous post has said. (Totto) However, I do have Aneamia and I get my Ferritin Levels checked for Iron count every 3 Months, and I take Iron tablets daily that I get on Prescription. P.S. Forgot to say I have been taking Metformin for 15 years now. Does anyone knows if Metformin can cause anemia? I am so tired and keep getting chest infections If You have used Metformin for a long period, then you have probably to low Cobalamin ( B12 ) vitamin. The treatment is with injections of B12 vitamin or with B12 tablets. Ask Your Doctor for help. He or she can make a blood analysis for B12, cobalamin. Does anyone knows if Metformin can cause anemia? I am so tired and keep getting chest infections I have been type 2 for 22 years and on insulin for last three years as well as metformin. I became anemic about 10 years ago had all the tests but never found a cause. At first I had iron infusions every 6 months for three years. Now on iron tablets. Then three years ago I was told I was B12 deficient as well due to metformin which stops your gut absorbing B12 so am now on B12 tablets as well. I have been type 2 for 22 years and on insulin for last three years as well as metformin. I became ane Continue reading >>

Type 2 Diabetes Diagnosis Distorted Through Hba1c Due To Anemia

Type 2 Diabetes Diagnosis Distorted Through Hba1c Due To Anemia

New research shows that anemia could lead to a false diagnosis of type 2 diabetes if HbA1c is used as the diagnostic method. In the UK, HbA1c is advocated by the World Health Organisation (WHO) for diagnosing type 2 diabetes at a value of 6.5 per cent (48 mmol/mol). Anemia is a common condition in which a lack of iron in the body leads to decreased red blood cell count or hemoglobin in patients. An estimate from 2011 found that 29 per cent of non-pregnant women had anemia, while the latest WHO figures suggest this figure is 13 per cent in men. Researchers at the University of Nottingham investigated studies between 1990 and 2014 in which HbA1c and glucose were measured, as well as an index of anemia involving non-pregnant women not diagnosed with diabetes. 12 studies found that iron deficiency with or without anemia resulted in increased HbA1c values, while no corresponding blood glucose rise occurred. Subsequently, a diagnosis of diabetes would require further testing. The researchers recommend that when glucose and HbA1c levels differ in diabetic patients, anemia or iron deficiency should be considered. If these abnormalities are identified, correction of high hemoglobin levels should be corrected before HbA1c is again used for diagnosis or monitoring. "HbA1c is likely to be affected by iron deficiency and iron deficiency anaemia with a spurious increase in HbA1c values. This may lead to confusion when diagnosing diabetes using HbA1c," the authors say. "This review clearly identifies the need for more evidence, especially in identifying the types and degrees of anaemia likely to have significant impact on the reliability of HbA1c." Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being in Continue reading >>

Diabetes And Anemia:

Diabetes And Anemia:

There are lots of articles about diabetes, as well as all kinds of information about anemia. But what if you have both? About 25 percent of people with diabetes have some level of anemia. This article explains how the two conditions interact. What Is Anemia, and Why Is It Linked to Diabetes? In anemia, there are fewer red blood cells than normal, resulting in less oxygen being carried to the body’s cells. People with anemia often feel tired or weak and may have difficulty getting through activities of daily living. Other symptoms include paleness, poor appetite, dizziness, lightheadedness, rapid heartbeat, and shortness of breath. Because these symptoms can also be associated with diabetes, they are sometimes not recognized as evidence of anemia. Anemia may occur with diabetes because the hormone that regulates red blood cell production, erythropoietin (EPO), is produced by the kidneys. Kidney damage at several levels is a complication of diabetes, and one problem often leads to the other. Changes in the kidneys that occur with diabetes range from diabetic nephropathy all the way to chronic kidney disease. Early detection and treatment is essential to prevent or delay disease progression. Information in greater detail can be found at www.kidney.niddk.nih.gov. Other causes of anemia are low levels of iron or other vitamins, as well as prolonged illness. Diagnosing Anemia A simple blood test done during a doctor visit, called a complete blood count or CBC, is used to check for anemia. The two elements of the test that reveal anemia are hemoglobin and hematocrit. Hemoglobin is the part of red blood cells that carries oxygen to the cells. Hematocrit indicates the percentage of red blood cells in the blood. How Does Anemia Affect Your Diabetes Care? If you have anemia, you Continue reading >>

Anemia And Diabetes - Fulltext - American Journal Of Nephrology 2004, Vol. 24, No. 5 - Karger Publishers

Anemia And Diabetes - Fulltext - American Journal Of Nephrology 2004, Vol. 24, No. 5 - Karger Publishers

World Health Organization statistics identify 150 million people with diabetes mellitus worldwide and suggest that this figure may double by 2025. In countries with a western lifestyle, the number of patients admitted for renal replacement therapy with diabetes as a co-morbid condition has increased significantly up to three to four times in a period of 10 years. Diabetes and renal failure are thus tightly linked diseases, and so is anemia. However, whether anemia may be worsened and/or directly, at least in part, caused by diabetes is not clearly elucidated yet. In this article, we review the prevalence, pathophysiology and consequences of anemia in diabetic patients. End-stage renal disease (ESRD) in diabetes mellitus patients has been called a medical catastrophe of worldwide dimension [ 1 ]. World Health Organization statistics identify 150 million people with diabetes mellitus worldwide and suggest that this figure may double by 2025. In countries with a western lifestyle, the number of patients admitted for renal replacement therapy with diabetes as a co-morbid condition has increased significantly up to three to four times in a period of 10 years [ 2 ]. Consequently, diabetes is the single most common cause of end-stage renal disease and therefore the most common cause of renal anemia. In this article, we review the prevalence, pathophysiology and consequences of anemia in diabetic patients. Prevalence of Anemia in Diabetic Patients Patients with diabetes suffer the consequences of impaired renal function earlier in the course of their disease than do their non diabetic counterparts [ 3 , 4 , 5 , 6 , 7 ]. In diabetic nephropathy (DN), anemia tends to be more severe than in non-diabetic renal disease and occurs at an earlier stage of the disease. However, because Continue reading >>

Anemia Can Lead To False Type 2 Diabetes Diagnosis, Research Shows

Anemia Can Lead To False Type 2 Diabetes Diagnosis, Research Shows

[shareaholic app="share_buttons" id="18113159"] Anemia can lead to a false type 2 diabetes diagnosis, according to research. Anemia is a condition where there is fewer red blood cells found in the bloodstream than normal. This can be due to lack of iron which is necessary for red blood cells and can leave a person feeling low-energy, dizzy, low appetite, short of breath and with a rapid hear beat. Anemia can also be seen in diabetics because an essential hormone which regulates red blood cell production is created by the kidneys and kidney damage is a known complication of diabetes which can then contribute to anemia. New research highlights how anemia can lead to false diagnosis of diabetes A fairly recent study revealed how anemia can lead to a false diagnosis of diabetes. A common form of diagnosis for type 2 diabetes is with glycated haemoglobin (sugar-bound haemoglobin, or HbA1c) but if a person has anemia it may reveal that they have blood sugar problems even when they really don’t. For the study the researchers utilized a systemic review which included studies from 1990 to 2014. The researchers found that an iron deficiency with or without anemia increased the values of HbA1c compared to controls. Therefore a diagnosis of diabetes in these patients would be unreliable without the help of further testing. The authors explained, “HbA1c is likely to be affected by iron deficiency and iron deficiency anaemia with a spurious increase in HbA1c values. This may lead to confusion when diagnosing diabetes using HbA1c. This review clearly identifies the need for more evidence, especially in identifying the types and degrees of anaemia likely to have significant impact on the reliability of HbA1c.” Recommendations form the authors included: If results are different co Continue reading >>

Anemia In Type 2 Diabetic Patients And Correlation With Kidney Function In A Tertiary Care Sub-saharan African Hospital: A Cross-sectional Study

Anemia In Type 2 Diabetic Patients And Correlation With Kidney Function In A Tertiary Care Sub-saharan African Hospital: A Cross-sectional Study

Anemia in type 2 diabetic patients and correlation with kidney function in a tertiary care sub-Saharan African hospital: a cross-sectional study Department of Internal medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon Health and Human Development (2HD) Research Group, P.O. Box 4856, Douala, Cameroon Department of Internal medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon Health and Human Development (2HD) Research Group, P.O. Box 4856, Douala, Cameroon Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Cameroon Department of Internal medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon Health and Human Development (2HD) Research Group, P.O. Box 4856, Douala, Cameroon Diabetes and Endocrine Unit, Department of Internal Medicine, Douala General Hospital, Douala, Cameroon South African Medical Research Council, and University of Cape Town, Cape Town, South Africa Department of Surgery, Obstetric and Gynecology, Faculty of Health Sciences, University of Buea, Buea, Cameroon Vitalis F. Feteh, Email: [email protected] . Received 2015 Mar 7; Accepted 2016 Mar 17. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. This article has been cited by other articles in PMC. Anemia is common i Continue reading >>

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