Incidence and risk of anemia in type-2 diabetic patients in the absence of renal impairment
Babatunde Ishola Adejumo, Uchechukwu Dimkpa, Chinwe Obianuju Ewenighi, Abduffatah Adekunle Onifade, Azukaego Thomas Mokogwu, Tosan Amos Erhabor, Esmond Ukatu, Isaac Nwoye Nnatuanya
Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Chemical Pathology, School of Clinical Medicine, Igbinedion University, Okada, Nigeria.
Department of Chemical Pathology/Toxicology, Faculty of Medical Lab Sciences, Elele Campus, Madonna University, Okija, Nigeria.
Education and Research Department, May and Baker Plc, Lagos, Nigeria.
Medical Laboratory Sciences Department, Ebonyi State University, Abakaliki, Nigeria.
Medical Laboratory Sciences Department, University of Benin, Benin City, Nigeria.
Physiology Department, Nnewi Campus, Nnamdi Azikiwe University, Awka, Nigeria.
Research and Training Department, Medical Laboratory Science Council of Nigeria, Abuja, Nigeria.
DOI: 10.4236/health.2012.46050   PDF    HTML     5,117 Downloads   11,021 Views   Citations

Abstract

Aim: To determine the incidence of anemia in type-2 diabetic patients with normal renal function and assess the association of other factors related to diabetes with the risk of anemia. Methods: The study group comprised 72 patients with type-2 diabetes. Patients were divided into groups according to glycemic control, gender and age. Serum creatinine, hematocrit, hemoglobin concentration, blood glucose and glycated hemoglobin (HbA1c) of subjects were measured. The presence of anemia was defined by a he- moglobin level < 13.0 g/dL in men and <12.0 g/dL in women. Normal renal function (i.e. absence of renal impairment) was defined as serum creatinine level < 1.5 mg/dL. Results: 15.3% of the patients had anemia. The odds of developing anemia was higher in patients with poorly controlled diabetes (HbA1c > 7.5%) compared to those with controlled diabetes (≤7.5%) and in patients of age ≥ 60 yrs compared to those of age < 60 yrs (p < 0.05). The odds of anemia was similar in males and females (p = 0.26). Conclusion: This study indicated that poor glycemic control and old age are associated with the incidence of anemia in type-2 diabetics with normal renal function. Our findings suggest that treatment criteria for diabetes should include routine hematological tests and take into consideration the inevitable consequences of ageing, and poor glycemic control.

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Adejumo, B. , Dimkpa, U. , Ewenighi, C. , Onifade, A. , Mokogwu, A. , Erhabor, T. , Ukatu, E. and Nnatuanya, I. (2012) Incidence and risk of anemia in type-2 diabetic patients in the absence of renal impairment. Health, 4, 304-308. doi: 10.4236/health.2012.46050.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Thomas, M.C., MacIsaac, R.J., Tsalamandris, C., Molyneaux, L., Goubina, I., Fulcher, G., Yue, D. and Jerums, G. (2004) The burden of anaemia in type 2 diabetes and the role of nephropathy: A cross-sectional audit. Nephrology Dialysis Transplantation, 19, 1792-1797. doi:10.1093/ndt/gfh248
[2] Bosman, D.R., Winkler, A.S., Marsden, J.T., Macdougall, I.C. and Watkins, P.J. (2001) Anaemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care, 24, 495-499. doi:10.2337/diacare.24.3.495
[3] Dikow, R., Schwenger, V., Schomig, M. and Ritz, E. (2002) How should we manage anaemia in patients with diabetes? Nephrology Dialysis Transplantation, 17, 67-72. doi:10.1093/ndt/17.suppl_1.67
[4] Ishimura, E., Nishizawa, Y., Okuno, S., Matsumoto, N., Emoto, M., Inaba, M., Kawagishi, T., Kim, C.W. and Morii, H. (1998) Diabetes mellitus increases the severity of anaemia in non-dialysed patients with renal failure. Journal of Nephrology, 11, 83-86.
[5] El-achkar, T.M., Ohmit, S.E., Mccullough, P.A., Crook, E.D., Brown, W.W., Grimm, R., Bakris, G.I., Keane, W.F. and Flack, J.M. (2005) Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. Kidney International, 67, 1483-1488. doi:10.1111/j.1523-1755.2005.00226.x
[6] Craig, K.J., Williams, J.D., Riley, S.G., Smith, H., Owens, D.R., Worthing, D., Cavill, I. and Phillips, A.O. (2005) Anemia and diabetes in the absence of nephropathy. Diabetes Care, 28, 1118-1123. doi:10.2337/diacare.28.5.1118
[7] Kojima, K. and Totsuka, Y. (1995) Anemia due to reduced serum erythropoietin concentration in non-uremic diabetic patients. Diabetes Research and Clinical Practice, 27, 229-233. doi:10.1016/0168-8227(95)01042-C
[8] World Health Organization (1968) Nutritional anaemia. Report of a WHO Scientific Group, WHO, Geneva, 1968.
[9] Bonakdaran, S., Gharebaghi, M. and Vahedian, M. (2011) Prevalence of anemia in type-2 diabetes and role of renal involvement. Saudi Journal of Kidney Diseases and Transplantation, 22, 286-290.
[10] Ahmed, A.M., Hussein, A. and Ahmed, N.H. (2000) Diabetic autonomic neuropathy. Saudi Medical Journal, 21, 1034-1037.
[11] Toyry, J.P., Niskanen, L.K., Mantyseari, M.J., Lansimies, E.A. and Uusitupa, M.I. (1996) Occurrence, predictors and clinical significance of autonomic neuropathy in NIDDM. Ten year follow-up from the diagnosis. Diabetes, 45, 308-315. doi:10.2337/diabetes.45.3.308
[12] Cottone, S., Lorito, M.C., Riccobene, R., Nardi, E., Mule, G., Buscemi, S., Geraci, C., Guarneri, M., Arsena, R. and Cerasola, G. (2008) Oxidative stress, inflammation and cardiovascular disease in chronic renal failure. Journal of Nephrology, 21, 175-179
[13] Schuster, S.J., Koury, S.T., Bohrer, M., et al. (1992) Cellular sites of extrarenal and renal erythropoietin production in anaemic rats. British Journal of Haematology, 81, 153-159. doi:10.1111/j.1365-2141.1992.tb08200.x
[14] Andersson, B., Marin, P., Lissner, L., et al. (1994) Testosterone concentrations in women and men with NIDDM. Diabetes Care, 17, 405-411. doi:10.2337/diacare.17.5.405
[15] Salive, M.E., Cornoni-Huntley, J., Guralnik, J.M., Phillips, C.L., Wallace, R.B., Ostfeld, A.M. and Cohen, H.J. (1992) Anemia and hemoglobin levels in older persons: Relationship with age, gender, and health status. Journal of the American Geriatrics Society, 40, 489-496.
[16] Gaskell, H., Derry, S., Moore, R.A. and McQuay, H.J. (2008) Prevalence of anaemia in older persons: Systematic review. BMC Geriatrics, 8, 1. doi:10.1186/1471-2318-8-1
[17] Goldhaber, A., Ness-Abramof, R. and Ellis, M.H. (2009) Prevalence of anemia among unselected adults with diabetes mellitus and normal serum creatinine levels. Endocrine Practice, 15, 714-719. doi:10.4158/EP09119.ORR
[18] Ahmed, A.T., Go, A.S., Warton, E.M., Parker, M.M. and Karter, A.J. (2010) Ethnic differences in anemia among patients with diabetes mellitus: The Diabetes Study of Northern California (DISTANCE). American Journal of Hematology, 85, 57-61.

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