Anemia often develops in type 2 diabetics

NEW YORK, Nov 24 (Reuters) In patients with type 2 diabetes, a decrease in hemoglobin (Hb) is insidious and occurs predominantly in older people with chronic kidney disease and damaged large blood vessels, research suggests.

''The early identification of anemia may be achieved by annual or biannual screening in these high-risk groups,'' Dr Merlin C Thomas from the Baker Medical Research Institute in Melbourne, Australia, told Reuters Health.

Anemia 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, hemoglobin. A lack of iron in the diet or blood loss, perhaps from internal bleeding or diseased blood vessels, are two potential causes of anemia.

''Anemia is now recognized as another problem in patients with diabetes, which develops earlier and is more severe in patients with diabetic kidney disease,'' Thomas said.

In a five-year prospective study of roughly 500 type 2 diabetics, Thomas and colleagues found that 12 per cent had anemia at baseline and an additional 13 per cent developed anemia during follow-up.

Overall, Hb levels fell by -0.07 grams per deciliter per year.

This suggests that anemia is ''the endpoint of a process that begins more than 10 years previously, with the initiation of microvascular (small blood vessel) damage,'' Thomas and colleagues write in the American Journal of Kidney Diseases.

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.

''These data,'' Thomas concludes, ''are important for developing a rational response to prevention and early management of anemia in individuals with diabetes.'' REUTERS AB VV0942