Diabetes mellitus with normal renal function is associated with anaemia

Diabetes Metab Res Rev. 2014 May;30(4):291-6. doi: 10.1002/dmrr.2491.

Abstract

Background: Anaemia is a common complication of diabetes mellitus (DM), usually related to renal failure. There is scarce information as to the levels of haemoglobin (Hb) and the rate of anaemia in diabetic patients with normal renal function. We, therefore, evaluated haemoglobin levels and the rate of anaemia in diabetic subjects with normal renal functions [estimated glomerular filtration rate (eGFR) > 60 mL/min].

Methods: The charts of 9250 subjects who attended the Institute of Periodic Medical Examinations at the Chaim Sheba Medical Center for a routine yearly check-up were reviewed. Four hundred and forty-five subjects with type 2 DM and normal renal function were indentified and compared with those without DM who were routinely examined at the same time. Subjects' electronic records were used to build a biochemical and clinical database.

Results: Mean haemoglobin levels were lower in subjects with DM than in those without (14.2 vs. 14.7 g/dL, respectively; p < 0.001). Anaemia was observed in 48 (10.8%) subjects in the diabetic group and in only 12 (2.7%) in the nondiabetic group (p < 0.001). Multivariate analysis revealed that age, gender, history of gastrointestinal disease, use of beta blockers, renal function and DM were independent determinants of haemoglobin levels. After adjustment for age, gender, history of gastrointestinal tract diseases and renal function, DM remained a significant determinant of anaemia with an odds ratio of 2.15 (confidence interval: 1.07-4.31).

Conclusions: Anaemia is more common in diabetic patients even when eGFR > 60 mL/min.

Keywords: anaemia; diabetes mellitus; haemoglobin; renal functions.

MeSH terms

  • Aged
  • Anemia / chemically induced
  • Anemia / complications*
  • Anemia / epidemiology
  • Anemia / etiology
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Nephropathies / complications*
  • Diabetic Nephropathies / drug therapy
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / physiopathology
  • Electronic Health Records
  • Female
  • Glomerular Filtration Rate
  • Hematopoiesis / drug effects
  • Hemoglobins / analysis
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Israel / epidemiology
  • Kidney / physiopathology*
  • Male
  • Middle Aged
  • Prevalence
  • Renal Insufficiency / complications*
  • Renal Insufficiency / drug therapy
  • Renal Insufficiency / epidemiology
  • Renal Insufficiency / physiopathology
  • Risk Factors
  • Sex Factors

Substances

  • Antihypertensive Agents
  • Hemoglobins
  • Hypoglycemic Agents