A comparative study of anaemia with the degree of glycaemic control in type 2 diabetes mellitus

Abstract

Background: Anaemia is one of the world’s most common preventable condition yet it is often overlooked especially in people with Diabetes Mellitus. Anaemia is a common finding in patients with diabetes. Anaemia in patients with diabetes mellitus might contribute to the pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. This aims to study the correlation between HbA1c and blood glucose levels in anaemic diabetics in order to assess the influence of anaemia on HbA1c and the effect of severity and type of anaemia on HbA1c.Methods: It’s a case control study, 200 Diabetic subjects were divided into two groups of 100 each based on their HbA1c levels group A, with good glycaemic control (HbA1c<7) and group B with poor glycaemic control (HbA1c>7), incidence of anaemia was measured and compared among them and also with 100 age and sex matched healthy non Diabetic controls. Results: In this study, it was found that high incidence of anaemia was found significantly higher in diabetics group with poor glycaemic control. Anemia was detected in 55% of patients among diabetic patients. Anaemia was seen in 71% of patients in group B with poor glycaemic control as compared to group A with good glycaemic control, in which only 39% of patients had anaemia. Mean haemoglobin was significantly lower that is, 10.81±3.0 in group with poor glycaemic control as compared to group with good glycaemic control i.e. 13.04±2.02. There was a statistically significant negative correllation between Haemoglobin percentage and HbA1c.Conclusion: Anaemia is a common finding in patients with diabetes. Diabetes related chronic hyperglycaemia can lead to a hypoxic environment in the renal interstitium which results in impaired production of erythropoietin by the peritubular fibroblasts and subsequently anaemia occurs. Anaemia in patients with diabetes mellitus might contribute to pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. However, an emphasis on regular screening for anaemia, alongside that for other diabetes related complications, might help to delay the progression of vascular complication in these patients.