Incidence of anemia in type 2 diabetic mellitus and its prognostic index
Abstract
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 60±13 were mean duration of diabetes being 4.1±3 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 8.4±2.1. 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.
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References
P. F. Pereira, R. D. C. G. Alfenas, and R. M. breastfeedingA.Ara´ujo influence the risk of developing diabetes mellitus in children, vol. 90, no. 1, pp. 7–15, 2014.doi: https://doi.org/10.1016/j.jped.2013.02.024.
Ramachandran A, Snehalatha C. Current scenario of diabetes in India. J Diabetes. 2009 Mar;1(1):18-28. doi: https://doi.org/10.1111/j.1753-0407.2008.00004.x. Epub 2008 Dec 17.
Ramachandran A, Das AK, Josh SR, Yajnik CS, Shah S, Prasanna Kumar KM. Current status of diabetes in india and need for novel therapeutic agents . JAPI. 2010 June; 58(sup 3):7-9.http://japi.org/june_special_issue_2010/Article_02.pdf.
Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, Rao PV, Yajnik CS, Prasanna Kumar KM, Nair JD; Diabetes Epidemiology Study Group in India (DESI). High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001 Sep;44(9):1094-101.doi: https://doi.org/10.1007/s001250100627.
Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007 Mar;125(3):217-30.http://www.ijmr.org.in/temp/IndianJMedRes1253217-2708844_073128.pdf.
Mohan V, Deepa R. Prevalence of diabetes and metabolic syndrome among Asians. International Journal of Diabetes in Developing Countries. 2010 Oct –Dec;30(4):173-5.
Brasil Minist´erio da Sa´ude, Diretrizes da Sociedade Brasileira de Diabetes 2013- 2014, AC Farmacˆeutica,2014.
Wright JA, Oddy MJ, Richards T. Presence and characterisation of anaemia in diabetic foot ulceration. Anemia. 2014;2014:104214. doi: https://doi.org/10.1155/2014/104214. Epub 2014 Jul 23.
Abate A, Birhan W, Alemu A. Association of anemia and renal function test among diabetes mellitus patients attending Fenote Selam Hospital, West Gojam, Northwest Ethiopia: a cross sectional study. BMC Hematol. 2013 May 7;13(1):6. doi: https://doi.org/10.1186/2052-1839-13-6.
Thomas MC, Cooper ME, Rossing K, Parving HH. Anaemia in diabetes: Is there a rationale to TREAT? Diabetologia. 2006 Jun;49(6):1151-7. Epub 2006 Apr 4.doi: https://doi.org/10.1007/s00125-006-0215-6.
El-Achkar TM, Ohmit SE, McCullough PA, Crook ED, Brown WW, Grimm R, Bakris GL, Keane WF, Flack JM; Kidney Early Evaluation Program. Higher prevalence of anemia with diabetes mellitus in moderate kidney insufficiency: The Kidney Early Evaluation Program. Kidney Int. 2005 Apr;67(4):1483-8.doi: https://doi.org/10.1111/j.1523-1755.2005.00226.x.
New JP, Aung T, Baker PG, Yongsheng G, Pylypczuk R, Houghton J, Rudenski A, New RP, Hegarty J, Gibson JM, O'Donoghue DJ, Buchan IE. The high prevalence of unrecognized anaemia in patients with diabetes and chronic kidney disease: a population-based study. Diabet Med. 2008 May;25(5):564-9. doi: https://doi.org/10.1111/j.1464-5491.2008.02424.x.
Nadia Shams, M.H. Osmani. Newly Diagnosed Anemia in Admitted Diabetics, Frequency, Etiology and Associated Factors. Journal of the College of Physicians and Surgeons Pakistan 2015, Vol. 25 (4): 242-246. https://pdfs.semanticscholar.org/dc51/55a9d52fc8cc4265789dd6b000c9d4be009e.pdf.
Trevest K, Treadway H, Hawkins-van der Cingel G, Bailey C, Abdelhafiz AH. Prevalence and determinants of anemia in older people with diabetes attending an outpatient clinic: a cross-sectional audit. Clin Diabetes. 2014 Oct;32(4):158-62. doi: https://doi.org/10.2337/diaclin.32.4.158.
Marathias KP, Agroyannis B, Mavromoustakos T, Matsoukas J, Vlahakos DV. Hematocrit-lowering effect following inactivation of renin-angiotensin system with angiotensin converting enzyme inhibitors and angiotensin receptor blockers. Curr Top Med Chem. 2004;4(4):483-6.doi: https://doi.org/10.2174/1568026043451311.
Dousdampanis P, Trigka K, Fourtounas C. Prevalence of anemia in patients with type II diabetes and mild to moderate chronic kidney disease and the impact of anti-RAS medications. Saudi J Kidney Dis Transpl. 2014 May;25(3):552-7.doi: https://doi.org/10.4103/1319-2442.132178.
Silverberg DS, Wexler D, Blum M, Tchebiner JZ, Sheps D, Keren G, Schwartz D, Baruch R, Yachnin T, Shaked M, Schwartz I, Steinbruch S, Iaina A. The effect of correction of anaemia in diabetics and non-diabetics with severe resistant congestive heart failure and chronic renal failure by subcutaneous erythropoietin and intravenous iron. Nephrol Dial Transplant. 2003 Jan;18(1):141-6.doi: https://doi.org/10.1093/ndt/18.1.141.
World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva : world health organization ;2010.https://apps.who.int/iris/bitstream/handle/10665/85839/WHO_NMH_NHD_MNM_11.1_eng.pdf?ua=1.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53.doi: https://doi.org/10.2337/diacare.27.5.1047.
Thomas M, Tsalamandris C, MacIsaac R, Jerums G. Anaemia in diabetes: an emerging complication of microvascular disease. Curr Diabetes Rev. 2005 Feb;1(1):107-26.doi: https://doi.org/10.2174/1573399052952587.
Osama El, MinshawyEman El. Anemia and Kidney Dysfunction in Type 2 Diabetic Patients. Nephrourology monthly. 2010 Sep; 02(04):543-52.http://numonthly.com/en/articles/71499.html.
Cristoph H. Anaemia in Patients with Diabetic Nephropathy – Prevalence, Causes and Clinical Consequences . European Cardiovascular Disease 2007.doi: http://dx.doi.org/10.15420/ecr.2007.0.1.80.