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Causes Of Anemia In Diabetes Mellitus

Nephro-urology Monthly

Nephro-urology Monthly

Anemia and Microvascular Complications in Patients With Type 2 Diabetes Mellitus 1 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran 2 Department of Hematology, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran 3 Students Center for Medical Research, Baqiyatallah University of Medical Sciences, Tehran, IR Iran 4 Endocrinology and Metabolism Department, Baqiyatallah University of Medical Sciences, Tehran, IR Iran * Corresponding author: Zohreh Rostami, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121544897, Fax: +98-2181262073, E-mail: [email protected] Nephro-Urology Monthly: July 2014, 6 (4) ; e19976 To Cite: Hosseini M S, Rostami Z, Saadat A, Saadatmand S M, Naeimi E. et al. Anemia and Microvascular Complications in Patients With Type 2 Diabetes Mellitus, Nephro-Urol Mon. 2014 ;6(4):e19976. doi: 10.5812/numonthly.19976 . Background: Although chronic kidney disease-induced anemia is more prevalent in patients with diabetes mellitus (DM), anemia is a common finding prior to manifestation of kidney disease. In presence of some risk factors at the time of diagnosing DM, microvascular complications must be considered. The effect of anemia as a risk factor on progression of DM complications is still unclear. Objectives: The aim of the study was to determine the prevalence of anemia and its association with microvascular complications in patients with type 2 DM. Patients and Methods: This cross-sectional study was performed in the outpatient endocrinology clinic at Baqiyatallah University of Medical Sciences Hospital, Tehran, Iran. Study was done from February 2011 to February 2012. Patients with type 2 DM without any obvio Continue reading >>

Anemia In Diabetic Patients: Could You Be At Risk?

Anemia In Diabetic Patients: Could You Be At Risk?

This review examined the various factors which increase the risk of diabetics developing anemia. Anemiais a condition in which the tissues in the bodyreceive less oxygenthan needed. This can be due to a reduction in the number of red blood cells (cells which transport oxygen in the blood). However, it may also be occur if a patient is deficient in iron (metal which binds to the red blood cells to carry the oxygen). Anemia is quite frequent in patients with diabetes, although it is not known why. It is important to be able toidentify patients with anemia early in order to prevent complicationswhich occur as a result of being anemic. These complications may includesevere fatigue and an abnormal heart rate. This review aimed to identify the causes of anemia in diabetics, in the hope of identifying certain factors which may indicate that a diabetic has anemia. The cause of anemia in patients with type 1 diabetes (T1D) is often linked to another autoimmune disease (disease in which the bodys immune system attacks its tissues). 510% of T1D patients also suffer fromautoimmune gastritis(inflammation of stomach). These patients are more likely to have anemia.Pernicious anemia(deficiency of vitamin B12 which results in a lack of red blood cell growth) also occurs in 2.64% of diabetics. Other autoimmune diseases such asceliac disease(inflammation of the intestines due to reaction to gluten, a protein found in wheat) andhypothyroidism(lack of functioning thyroid) areassociated with anemia in diabetics. 32% of patients with type 2 diabetes (T2D) have anemia. Insulin (hormone that lowers blood glucose levels) is needed for the growth of red blood cells. However, the lack of insulin action in T2D patients may result in anemia. Drugs such asmetformin (Glucophage)are known tocause anem Continue reading >>

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 >>

Diabetes Mellitus & Immune Mediated Hemolytic Anemia :: Case Study :: Asg Los Angeles

Diabetes Mellitus & Immune Mediated Hemolytic Anemia :: Case Study :: Asg Los Angeles

Diabetes Mellitus and Immune Mediated Hemolytic Anemia Lethargy and inappetence in a diabetic Bichon Frise reveal two diseases: Primary Immune Mediated Hemolytic Anemia (IMHA) and Diabetes Mellitus. Reyna, a 10-year-old spayed female Bichon Frise, was referred to ASG for management of two difficult disease processes. She had previously been a well-regulated diabetic receiving 5 units of NPH insulin twice daily, when she presented to her primary care veterinarian for lethargy and inappetence. Complete bloodwork performed at her primary veterinarians office revealed a marked regenerative anemia, hyperbilirubinemia and macro autoagglutination on a saline slide agglutination test. These findings were consistent with immune mediated hemolytic anemia. Her diabetes remained well controlled (no evidence of ketosis or acidosis was identified) at that time. Upon examining Reyna she was found to be febrile with a temperature of 103. Additionally, she was tachycardic and pale. Her PCV on admittance was 16%, for which she required a packed red blood cell transfusion and aggressive immunosupression. While a diagnosis of hemolytic anemia had already been confirmed by Reynas primary veterinarian, further diagnostics to determine if an underlying cause could be identified, were performed. Tick serology was found to be negative. Thoracic radiographs did not reveal any evidence of underlying neoplastic disease. Abdominal ultrasound revealed a large liver with homogenous slightly hyperechoic echotexure, a finding we see consistently with hemolytic anemia. Results confirmed a diagnosis of Primary Immune Mediated Hemolytic Anemia (IMHA) and Diabetes Mellitus (DM) Our treatment plan for Reyna was similar to most patients with IMHA however, given the risk of immunosuppressive steroids alterin 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 >>

The Relationship Between Hemoglobin Levels And Endothelial Functions In Diabetes Mellitus

The Relationship Between Hemoglobin Levels And Endothelial Functions In Diabetes Mellitus

The Relationship between Hemoglobin Levels and Endothelial Functions in Diabetes Mellitus *Departments of Endocrinology and Metabolism, Epidemiology, Glhane School of Medicine, Etlik Ankara, Turkey; Nephrology, Dialysis and Transplantation Unit and CNR-IBIM Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy Dr. Mahmut Ilker Yilmaz, Department of Nephrology, Glhane School of Medicine, 06018 Etlik, Ankara, Turkey. Phone: +90 312 3044076; Fax: +90 312 3042920; E-mail: mahmutiyilmaz{at}yahoo.com A.S. and M.I.Y. contributed equally to this work. Background and objectives: Hemoglobin (Hb) is the main carrier and buffer of nitric oxide. Evidence has been produced that Hb concentration is inversely related with endothelial function in human diseases. Testing whether this association exists also in diabetic patients stage 1 to 2 chronic kidney disease (CKD) is important because anemia in these patients starts at an earlier stage than in other renal diseases. The relationship was investigated between Hb and flow-mediated dilation (FMD) levels of the patients with diabetic nephropathy in a cross-sectional design. Design, setting, participants, & measurements: Eighty-nine diabetics with mild to moderate proteinuria and normal to mildly reduced GFR who were normotensive, nondyslipidemic, and cardiovascular-events free were enrolled. None of the patients was taking metformin or renin-angiotensin system blockers. Results: FMD was inversely related with Hb levels. Furthermore, there was an inverse link between proteinuria and FMD. However, further analysis of this association showed that the FMD-proteinuria link was confined to patients with proteinuria exceeding 150 mg/d, while no such association existed in patients with proteinuria Continue reading >>

Diabetes Mellitus Increases The Prevalence Of Anemia In Patients With Chronic Kidney Disease: A Nested Case-control Study

Diabetes Mellitus Increases The Prevalence Of Anemia In Patients With Chronic Kidney Disease: A Nested Case-control Study

Diabetes mellitus increases the prevalence of anemia in patients with chronic kidney disease: A nested case-control study Number of Hits and Downloads for This Article Jul 6, 2016 (publication date) through May 26, 2018 Baishideng Publishing Group Inc, 7901 Stoneridge Drive, Suite 501, Pleasanton, CA 94588, USA Copyright The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. World J Nephrol.Jul 6, 2016;5(4): 358-366 Published online Jul 6, 2016.doi: 10.5527/wjn.v5.i4.358 Diabetes mellitus increases the prevalence of anemia in patients with chronic kidney disease: A nested case-control study Charalampos Loutradis, Alexandra Skodra, Panagiotis Georgianos, Panagiota Tolika, Dimitris Alexandrou, Afroditi Avdelidou, Pantelis A Sarafidis Charalampos Loutradis, Pantelis A Sarafidis, Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece Alexandra Skodra, Panagiota Tolika, Dimitris Alexandrou, Afroditi Avdelidou, Hemodialysis Unit, General Hospital of Grevena, 52100 Grevena, Greece Panagiotis Georgianos, Section of Nephrology and Hypertension, 1st Department of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece Author contributions: Loutradis C performed the statistical analysis and wrote the manuscript; Skodra A, Tolika P, Alexandrou D collected study material; Georgianos P participated in the statistical analysis; Avdelidou A prospectively collected data and supervised the study material collection; Sarafidis PA designed the study, supervised the statistical analysis and edited the manuscript. Institutional review board statement: The study was reviewed and approved by the Review Board of General Hospital of Grevena. Informed consent statement: T 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 >>

Diabetes And Anemia: Are They Related?

Diabetes And Anemia: Are They Related?

Someone’s anemic if they have an abnormally low amount of red blood cells – and when there are too few red blood cells, body organs don’t get the oxygen they need. This not only strains and damages organs, but it also decreases a person’s quality of life by causing fatigue, weakness, and headaches. Red blood cells can transport oxygen because they’re full of a complex molecule called hemoglobin, which can grab, hold, and release oxygen as needed in different part of the body. A doctor may an anemic person as having “too little hemoglobin” or “a low hematocrit”. The first statement refers to the amount of concentration of hemoglobin molecules in your blood, and the second refers to the concentration of red blood cells in your blood. If that sounds redundant, you’re right! They’re both describing the same thing. That’s why it’s best to pay attention to one or the other (not both) to avoid confusion. Types of anemia There are quite a few different types of anemia (over 400 to be exact!). The most common ones are summarized below. It is very important to know the type of anemia and the cause. Without knowing the cause, you cannot treat the disease! Iron Deficiency. This is the most common type. It is caused by lack of absorption, intake, or by blood loss. Aplastic. This occurs when the body stops making new red blood cells. It is rare, but very serious. Hemolytic. This type happens when red blood cells are destroyed faster than they can be produced. Vitamin Deficiency. Poor nutrition, or impaired vitamin absorption causes this type. Pernicious. With this, the B-12 intake is okay, but the body cannot process it correctly. Fragile Red Cell. Some people inherit abnormal red blood cells that die earlier than normal, like in sickle cell or thalassemia. Continue reading >>

Incidence Of Anemia In Type 2 Diabetic Mellitus And Its Prognostic Index | Periasamy | International Journal Of Medical Research And Review

Incidence Of Anemia In Type 2 Diabetic Mellitus And Its Prognostic Index | Periasamy | International Journal Of Medical Research And Review

International Journal of Medical Research and Review Incidence of anemia in type 2 diabetic mellitus and its prognostic index S. Periasamy, Adhin Antony Xavier, R. Gowtham Objective: To identify the incidence of anemia in type 2 diabetic mellitus in a rural population and its prognostic value. Methodology: This is prospective observational study conducted at RMMCH, Chidambaram; the study comprises of 250 patients diagnosed with type 2 diabetic mellitus. Age of greater than 18 years, Risk factor such us hypertension and CAD were included in the study. Age of less than 18 years, anemia due to chronic blood loss, anemia due to other secondary causes and patient on treatment for anemia is excluded from the study. In patients with diabetic mellitus, HbA1c, Complete Blood Picture, Smear study, were done after obtaining consent detail from patients. Result: In the present study out of 250 populations females was dominated by 160/250(64%) with mean age group of 6013 were mean duration of diabetes being 4.13 years and mean hemoglobin level was 11.3 2%, the comorbid condition such us CAD and Hypertension was present in 90 and 110 patients respectively. Mean HbA1c value was 8.42.1. Normocytic Normochromic anemia was present in 25% of anemic patients; Microcytic Hypochromic anemia was found in 35%, Macrocytic Hyperchromic is 32% and Dimorphic anemia was present in 8%. Conclusion: Anemia is present in 74% of the study population which point towards the need of hematological evaluations and care needed for the diabetic patients for better outcome in rural population. P. F. Pereira, R. D. C. G. Alfenas, and R. M. breastfeedingA.Araujo influence the risk of developing diabetes mellitus inJornalPediatriachildren, vol. 90, no. 1, pp. 715, 2014. Ramachandran A, Snehalatha C. Current scen Continue reading >>

Anemia

Anemia

When “Tired Blood” is Slowing You Down Most people have heard of anemia and know that it has something to do with the blood. Most people also associate anemia with feeling tired. But probably not too many people could explain exactly what anemia is. Stated simply, anemia is a condition in which there is a lower than normal number of healthy red blood cells in the body and/or a lower than normal amount of hemoglobin in the red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body. The specific part of the red blood cell that carries oxygen is called hemoglobin. Red blood cells also carry waste products from the cells to the urinary and respiratory systems to be excreted. When either the number of red blood cells or the amount of hemoglobin is low, the body’s cells receive less oxygen than normal. A low oxygen level can cause fatigue and other symptoms such as weakness, difficulty exercising, and light-headedness. Anemia can develop for many reasons. In fact, there are more than 400 types of anemia. But they can all be categorized into these three general groups: Anemia caused by the loss of blood Anemia caused by a decrease in red blood cell production in the bone marrow or impaired production of red blood cells Anemia caused by red blood cell destruction Anemia is a fairly common condition, but it often goes unrecognized and therefore not treated. Its symptoms are vague and easily mistaken for symptoms of other serious or chronic diseases. But even mild anemia can significantly lower one’s quality of life, and untreated anemia can have serious long-term health effects. Diabetes and anemia Diabetes does not directly cause anemia, but certain complications and conditions associated with diabetes can contribute to it. For example, both 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 >>

Anaemia In Patients With Diabetes: Unrecognised, Undetected And Untreated?

Anaemia In Patients With Diabetes: Unrecognised, Undetected And Untreated?

Background: Diabetes mellitus is one of the two most common causes of end-stage renal disease and significant proportions of patients with diabetes mellitus develop renal complications. Anaemia is a key indicator of renal disease yet most patients with diabetes are rarely tested for anaemia and are unaware of the link between anaemia and kidney disease. Patients and Methods: A pan-European study was undertaken to assess patients' level of awareness and understanding of anaemia and of the complications of diabetes mellitus, and to determine the impact of anaemia on quality of life. The study comprised a questionnaire-based interview with 1054 respondents from six countries (Belgium, France, Germany, Greece, Italy and the UK). Ages ranged from 18 to 85, the average duration of diabetes was 15 years and 69% of respondents had type 2 diabetes mellitus. Results: Only 32% of respondents had been given information about anaemia, although 83% had heard of anaemia. Less than half were aware of being tested for anaemia and only 14% attributed anaemia to diabetes. Of 1054 respondents, 132 were known to be anaemic, one-fifth had received no treatment, 12 had received blood transfusions, five were receiving erythropoietin therapy and the remainder had been given iron and/or vitamin supplementation. Perceived state of health was worse in those with anaemia, 47% had either experienced periods of ill health or were feeling in poor health generally compared with only 28% of those without anaemia. Tiredness and lethargy were more marked in those with anaemia, 74% feeling tired and lethargic considerably more often or somewhat more often than others compared with only 52% of those without anaemia. With respect to complications of diabetes, respondents were most concerned about retinopath Continue reading >>

Higher Prevalence Of Anemia With Diabetes Mellitus In Moderate Kidney Insufficiency: The Kidney Early Evaluation Program - Sciencedirect

Higher Prevalence Of Anemia With Diabetes Mellitus In Moderate Kidney Insufficiency: The Kidney Early Evaluation Program - Sciencedirect

Volume 67, Issue 4 , April 2005, Pages 1483-1488 Clinical Nephrology Epidemiology Clinical Trials Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. The Kidney Early Evaluation Program (KEEP 2.0) cross-sectional, community-based study, targeted individuals at increased risk for kidney disease and measured blood glucose, creatinine, and hemoglobin. KEEP 2.0 screening data were used to determine the prevalence of anemia by level of kidney function and diabetes status. Estimated glomerular filtration rate (EGFR) was calculated using serum creatinine values, and categorized as 90, 6089, 3059 and <30 mL/min/1.73m2. Anemia was defined as hemoglobin <12 g/dL in men and in women aged >50 years, and <11 g/dL in women 50 years. Diabetes was defined as participant-reported diagnosis, fasting glucose >125 mg/dL, or nonfasting glucose >200 mg/dL. Data were available on 5380 participants screened from August 2000 through December 2001. Diabetes was present in 26.9% of participants, and anemia in 7.7%; 15.9% of participants had at least moderately reduced kidney function (EGFR <60 mL/min/1.73m2). In participants with diabetes, anemia prevalence at the 4 levels of descending EGFR were 8.7%, 7.5%, 22.2%, and 52.4%, compared with 6.9%, 5.0%, 7.9%, and 50.0% in persons without diabetes. In a multivariable model, participants of non-white race/ethnicity, those with diabetes and those with EGFR <30 or 3059 mL/min/1.73m2 had significantly increased odds of anemia. In addition, a significant sex-diabetes interaction was identified; odds of anemia were 4-fold greater in men than women with diabetes relat Continue reading >>

Anaemia In Diabetes.

Anaemia In Diabetes.

1. Acta Diabetol. 2004 Mar;41 Suppl 1:S13-7. (1)Diabetes and Endocrinology Day Centre, Lambeth Palace Road, SE1 7EH, London, UK. Anaemia is a common complication of chronic kidney disease (CKD). It is oftenmore severe and occurs at an earlier stage in patients with diabetic nephropathy than in patients with CKD of other causes. This anaemia results fromerythropoietin deficiency, which seems to develop in patients with type 1diabetes even at relatively "normal" levels of serum creatinine. Earlyerythropoietin- deficiency anaemia occurs in both type 1 and type 2 diabetes,although the prevalence may be higher in type 1 diabetes. However, numericallymost patients with erythropoietin-deficiency anaemia have type 2 diabetes as itis a much more common disease. There is also a greater prevalence in women thanmen but this is not related to iron stores. In addition,erythropoietin-deficiency anaemia is associated with the presence of autonomicneuropathy in patients with diabetes. Small studies have suggested thatrecombinant human erythropoietin (rhEPO; epoetin) treatment is effective incorrecting erythropoietin-deficiency anaemia in patients with diabetes.Additionally, rhEPO therapy improves quality of life and well-being in thesepatients. Studies also suggest that treatment with rhEPO to restore a normalhaematocrit ameliorates orthostatic hypotension. Given the high cardiovascularrisk in patients with diabetic nephropathy, it is important to determine inprospective clinical trials whether early anaemia correction can also improvecardiovascular outcomes. Continue reading >>

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