Prevalence of anemia of chronic disease and iron deficiency anemia among adult diabetic patients in Erbil City

Abdulqadir Hameed Abdulqadir; Ranan Kardagh Polus

doi:10.15218/zjms.2014.0013

Authors

Abdulqadir Hameed Abdulqadir Ministry of Health, directorate of Health, Erbil, Iraq.
Ranan Kardagh Polus Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2014.0013

Keywords:

Diabetes Mellitus, Anaemia, Erbil, Anaemia of chronic disease, Iron deficiency anaemia

Abstract

Background and objective: Anaemia is often an unrecognized complication of diabetes mellitus that has adverse effect on the progression of diabetes related complications. Contributors to its development include erythropoietin insufficiency and iron deficiency. The aim of this study was to assess the prevalence of iron deficiency anaemia and anaemia of chronic disease among diabetic patients. Methods: Over a period of six month from November 2010 to May 2011, 250 diabetic patients, attending Layla Qasim diabetic center were studied, their age ranged between 18-73 years. Venous blood samples were collected from each of them. A complete blood picture, iron study, HbA1c% and fasting blood glucose were performed. According to the duration of diabetes, patients were divided into three groups: group I patients (duration of diabetes < 5 years), group II (duration of diabetes between 5-9 years) and group III (duration of diabetes ≥10 years). Results: One hundred ten patients (44%) were found to have anaemia. The frequency of anaemia was more among group III (46.6%). Higher prevalence of anaemia was found among female patients (53.9%) than male patient (24.1%). Among anemic patients, 72 patients (65%) considered as having anaemia of chronic disease (ACD), 26 patients (24%) were iron deficiency anemia (IDA), 11 patients (10%) were thalassemia trait and one patient (1%) had autoimmune hemolytic anaemia. ACD was more frequent among group II (80%) and group III (70.4%), while IDA was more frequent among group I (12.6%). both ACD and IDA were more frequent among female patient than male patients (34.7% and 13.8% respectively). There was no significant correlation between HbA1c and Hb, serum iron parameters and S.ferritin. Conclusion: It was concluded that anaemia is common among diabetics and remains unrecognized by both physicians and patients; it is more common among female diabetics. The commonest type of anaemia among diabetic patients is ACD followed by IDA.

Metrics

Metrics Loading ...

References

American Diabetes Association. Diagnosis and Classification of diabetes mellitus. Diabetes Care 2006; Supp 1:543-8.

Leu JP, Zonszein J. Diagnostic Criteria and Classification of Diabetes. In: Leonid Poretsky editors. Principles of Diabetes Mellitus. 2nd ed. New York: Springer; 2010. PP 107-15.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Available at http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. [Accessed January 28, 2011]

Danaei G. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. The Lancet 2011; 378:31-40.

Thomas MC, Mac Isaac RJ, Salamandris T C, Power D, Jerums G. Unrecognized Anemia in Patients with Diabetes. Diabetes Care 2003; 26:1164-9.

Macdougall IC, Eckardt KU, Locatelli F. Latest US KDOQI Anaemia Guidelines update–what are the implications for Europe? Nephrol Dial Transplant; 2007; 22:2738-42.

Astor BC, Muntner P, Levin A, Eustace JA, Coresh J. Association of kidney function with anemia – The Third National Health and Nutrition Examination Survey. Arch Intern Med 2002; 1401-8

Rathi MS, Woodrow G, Mansfield MW. Prevalence of anaemia and the contribution of functional iron deficiency in diabetes related chronic kidney disease. Pract Diab Int 2006; 27:102-4

Adetunji OR, Mani H, Olujohungbe A, Ronald J, Morgan C, Gill GV. Prevalence and characteristics of anaemia in diabetes. Pract Diab Int 2008; 25:110-3.

Cawood TJ, Buckly U, Murray A, Corbett A, Dillon D, Goodwin B. Prevalence of anaemia in patients with diabetes mellitus. Ir J Med Sci 2006; 175:25-7

Thomas S, Stevens PE. Anaemia in diabetic kidney disease: an area for improvement? Pract Diab Int 2006; 23:22-6.

Bosman DR, Winkler AS, Marsden JT, Macdougall IC, Watkins PJ. Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care 2001; 24:495-9.

Coppack SW, Thursfield V, Dhar H, Hockaday TDR. Mild anemia is frequent and associated with micro- and macroangiopathies in patients with type 2 diabetes mellitus. JDI 2010; 1(6):273-8.

Bonakdaran S, Gharebaghi M, Vahedian M. Prevalence of anaemia in type 2 diabetes and role of renal involvement. Saudi J Kidney Dis Transpl 2011; 22:286-90.

Shi Z, Hu X, Yuan B, Pan X, Meyer HE, Holmboe-Ottesen G. Association between serum ferritin, haemoglobin, iron intake and diabetes in adults in Jiangsu, China. Diabetic Care 2006; 29:1878-83.

Almoznino-Sarafian D, Shteinshnaider M, Tzur I, Bar-Chaim A, Iskhakov E, Berman S, et al. Anaemia in diabetic patients at an internal medicine ward: Clinical correlation and prognostic significance. Eur J Intern Med 2011; 21:91-6.

Pasricha SR, Caruana SR, Phuc TQ, Casey GJ, Jolley D, Kingsland S, et al. Anemia, Iron deficiency, Meat consumption and Hookworm infection in women of reproductive age in northwest Vietnam. Am J Trop med Hyg 2008; 78:375-81.

Polus RK, Ahmed ZA. Prevalence of Haemoglobinopathies and iron deficiency anemia among marrying couples in Erbil province of Iraq. The N Iraqi J Med, “In press”.