Anaemia more common in diabetics

In patients with type 2 diabetes, a decrease in haemoglobin (Hb) is insidious and occurs predominantly in older people with chronic kidney disease and damaged large blood vessels. The early identification of anaemia may be achieved by annual or biannual screening in these high-risk groups. Anaemia 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, haemoglobin. Lack of iron in the diet or blood loss, perhaps from internal bleeding or diseased blood vessels, are two potential causes of anaemia. Anaemia is now recognised as another problem in patients with diabetes, which develops earlier and is more severe in patients with diabetic kidney disease. Researchers from the Baker Medical Research Institute in Melbourne, Australia, conducted a 5-year prospective study of roughly 500 type 2 diabetics and found that 12 percent had anaemia at baseline and an additional 13 percent developed anaemia during follow-up. Overall, Hb levels fell by 0.07 grams per decilitre per year. This suggests that anaemia is the endpoint of a process that begins more than 10 years previously, with the initiation of microvascular (small blood vessel) damage. 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. The above data are important for developing a rational response to prevention and early management of anaemia in individuals with diabetes.