PATTERN AND CAUSES OF ANEMIA IN YEMENI PATIENTS WITH TYPE 2 DIABETES MELLITUS
Jameel Al-Ghazaly*, Zayed Atef and Waled Al-Dubai
ABSTRACT
Background and aims. The data on the patten and causes of anemia in patients with Diabetes Mellitus in developing countries including Yemen is scarce. The aim of this study was to determine the pattern and causes of anemia in a group of patients with type 2 DM evaluated in Sana'a, Yemen. Methods: The study was a prospective descriptive and analytical cross-sectional study which recruited all patients with type 2 DM evaluated between March 2016 and March 2o17 at Al-Jomhori Teaching Hospital in Sana'a, Yemen. Results: 324 (141 males and 183 females) patients were included in the study. The mean age ±SD was 53±12 years. 77 (23.8%) patients (32 males and 45 females) had anemia. Significantly higher number of anemic patients had renal insufficiency i.e. eGFR <60 ml/min/1.73 m² (32.5% vs. 14.6%) and uncontrolled DM i.e. FBS <7.0 mmol/L (37.7% vs. 28.7%). Anemic patients were significantly older (mean age 55.58±11.37 vs. 52.27±12.05 years) with longer duration of DM (mean duration 71.23±84.08 vs. 48.87±63.43 months) and with lower eGFR (69.07±24.72 vs. 82.51±22.99 ml/min/1.73m²). Hb level showed significantly negative correlation with age, duration of DM and creatinine and positive correlation with the eGFR. 24 patients had iron deficiency anemia, 27 patients had CKD, 21 patients had inflammatory disorders and five patients had megaloblastic anemia. Anemic patients with renal insufficiency (eGFR <60 ml/min/1.73 m²) were older, had higher HbA1c (uncontrolled DM) and also had lower MCV and MCH. Conclusion: Anemic patients were older, with longer duration of DM, and were more frequently to have uncontrolled DM and renal impairment. Nutritional anemia including iron deficiency and megaloblastic anemia were common causes of anemia.
Keywords: Type 2 DM, Anemia, iron deficiency, megaloblastic anemia, causes, Yemen, Developing country.
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