Iron Deficiency Anemia in Children and Adolescents with Type I Diabetes, Is it a Real Problem?

Abstract

Background: Iron deficiency anemia (IDA) in children with type I diabetes (T1D) represents a significant burden. Aim of Study:To asses iron status in children and adolescent with T1D of and to correlate it with glycemic control and diabetic vascular complications.Patients and Methods: Two hundred children with T1D recruited from Pediatrics and Adolescent Diabetes Unit (PADU), Ain Shams University in the period from December 2019 to July 2020. They were 123 males (61.5%) and 77 females (38.5%) aged 10.97 ±3.93 years (Range: 2-18 years). History taking, fundus examination and general examination were done stressing on anthropometric measurements. Laboratory evaluation including complete blood count, glycosylated haemoglobin (HbA1c), urinary albumin/creatinine ratio (ACR), lipid profile and patients with microcytic hypochromic anaemia underwent Serum iron, total iron-binding capacity (TIBC), serum ferritin, Hepcidin, Anti-tissue transglutaminase (IgA), Occult blood in stool and H-pylori antigen in stool.Results: Seventy two of diabetic children were anemic (36%) and fifty one had IDA (25.5). IDA was more prevalent in males. Children with T1D and IDA experienced more clinically significant hypoglycemic attacks, more DKA attacks, high fatigue severity scale and history of menorrhagia. Low body weight, low BMI, low mean corpuscular volume (MCV), high TIBC and low hepcidin level were present in diabetic children with IDA. They also had high HbA1c, neuropathy, high triglycerides and high level of low density lipoprotein (LDL cholesterol).Conclusions: IDA is a significant morbidity among children with T1D and it should be screened. Serum hepcidin levels are significantly associated with iron status in children, and could be useful indicators of ID.