The progression of anemia in diabetes under different treatment modalities

Aims:Microvascular complications of diabetes are known to be decreased with intensive insulin treatment. However the effect of this treatment on anemia, which is almost a sine quo none sign in the course of diabetes, has not been clarified yet. Here in this study the patients with type 2 diabetes and without nephropathy were evaluated for the progress of anemia under different treatment modalities.Material and method:One hundred fifty patients with type 2 diabetes who attended to the outpatient diabetes clinics of Inonu University School of Medicine were evaluated retrospectively. The existence of any chronic disease and history of blood transfusion within last months; and the rate of glomerular filtration rate (GFR) less than 50 % were the exclusion criteria. Fifty patients with conventional insulin treatment (mixed insulin two times daily); 50 patients with intensive insulin regime (three premeal short acting/regular insulin with bedtime NPH daily) and 50 patients receiving hypoglycemic agents were evaluated for the existence of anemia and its course. Hematological and metabolic parameters were evaluated within 6-9 months in subsequent two visits.Results:Despite HbA1c levels were found to be significantly decreased with all treatment modalities, GFR was also found to be decreased in the second visit. Within all the three antidiabetic treatment modalities there was no statistical difference for the progression of anemia if followed without any anti-anemic treatment. The response to oral iron treatment in iron deficient group was comparable and successful within all diabetic groups.Conclusion:Intensive insulin treatment was not differently effective on the course of either the anemia of chronic disease (ACD) or course/ treatment responsiveness of iron deficiency. But on the scope of our clinical practice that intensive protocol has been used generally in bad controlled/complicated diabetics; these suggestion has to be improved with further studies.