Anemia Often Develops in Type 2 Diabetics: Study

In patients with type 2 diabetes, a decrease in hemoglobin (Hb) is insidious and occurs predominantly in older people with chronic kidney disease and damaged large blood vessels, research suggests. Dr. Merlin C. Thomas from the Baker Medical Research Institute in Melbourne, Australia stated that, "The early identification of anemia may be achieved by annual or biannual screening in these high-risk groups.”

Anemia occurs when there is a drop in the blood’s ability to carry oxygen, because of a deficiency in red blood cells or their oxygen-carrying component, hemoglobin. A lack of iron in the diet or blood loss, perhaps from internal bleeding or diseased blood vessels, are two potential causes of anemia.

"Anemia is now recognized as another problem in patients with diabetes, which develops earlier and is more severe in patients with diabetic kidney disease," Thomas said.

In a 5-year prospective study of roughly 500 type 2 diabetics, Thomas and colleagues found that 12 percent had anemia at baseline and an additional 13 percent developed anemia during follow-up.

Overall, Hb levels fell by -0.07 grams per deciliter per year. This suggests that anemia is "the endpoint of a process that begins more than 10 years previously, with the initiation of microvascular (small blood vessel) damage," Thomas and colleagues write in the American Journal of Kidney Diseases.

In patients with small blood vessel disease, decreasing Hb levels tracked with decreasing renal function. The rate of Hb decline was fastest in patients with established and progressive renal injury and large blood vessel or "macrovascular" disease at baseline.
"These data," Thomas concludes, "are important for developing a rational response to prevention and early management of anemia in individuals with diabetes."

American Journal of Kidney Diseases, October 2006.

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FACT:
Stroke happens more often in those with impaired glucose tolerance: To determine whether impaired glucose tolerance is associated with an increased likelihood for ischemic stroke. Researchers carried out a prospective cohort study among a sample of 1,032 people. They measured the association between impaired glucose tolerance and diabetes. Patients were examined in the year 1990 and followed up for stroke occurrence until death or until the end of 2002. Mean follow-up time was 9.6 years. In total, 119 patients (11.5%) suffered a stroke during the follow-up. In logistic regression model, previous stroke, previous TIA, DM and atrial fibrillation were risk factors for stroke occurrence.” The researchers concluded: “Stroke tended to happen more often in the impaired glucose tolerance group than in the normal group, but the difference was not statistically significant. Statistically significant risk factors for stroke in elderly people are previous TIA or stroke, DM and atrial fibrillation.
Age and Ageing 2006 35(6):592-596; doi:10.1093/ageing/afl094. November 2006