title: Treatment of a unique anemia in patients with IDDM with epoetin alfa.
abstract: OBJECTIVE
  To identify and treat a unique form of anemia in patients with long-term IDDM.
  
  
  METHODS
  Patients with IDDM, unexplained symptomatic anemia, and serum creatinine levels of < 177 mumol/l (2.0 mg/dl) were treated with epoetin alfa (Procrit, Ortho Biotech, Raritan, NJ), 50 U/kg three times weekly, subcutaneously, to reach a target hematocrit of 38-40%. Baseline serum erythropoietin titers were measured before drug therapy.
  
  
  RESULTS
  Six patients were treated with epoetin alfa. Median age of the group was 74 years, with IDDM being diagnosed for a median of > 20 years. All patients had symptoms of anemia with a median hematocrit of 28.9% (range 27-31). Compared with iron deficiency control patients, the group had a limited erythropoietin (EPO) response to the degree of anemia. All patients showed increases in hematocrit, median peak of 40.9%, with median time-to-peak response of 12 weeks. Baseline symptoms of anemia resolved in all patients. No adverse effects were noted during the treatment period.
  
  
  CONCLUSIONS
  There is a unique form of anemia in patients with long-term IDDM and clinically normal renal function who respond to low-dose epoetin alfa therapy. The rapid response to therapy and depressed baseline erythropoietin titers suggest the anemia is due to a lack of endogenous EPO release.
authors.affiliation: Division of Hematology/Oncology, Kaiser Permanente, Portland, Oregon 97227, USA. rarickma@chr.mts.kpnw.org
authors.forename: M U
authors.initials: MU
authors.lastname: Rarick
authors.forename: B M
authors.initials: BM
authors.lastname: Espina
authors.forename: D T
authors.initials: DT
authors.lastname: Colley
authors.forename: A
authors.initials: A
authors.lastname: Chrusoskie
authors.forename: S
authors.initials: S
authors.lastname: Gandara
authors.forename: D I
authors.initials: DI
authors.lastname: Feinstein
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000188:drug therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006397:Hematinics / Q000008:administration & dosage / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000378:metabolism; D011994:Recombinant Proteins; D016896:Treatment Outcome
chemical_list: D000068817:Epoetin Alfa; D004921:Erythropoietin; D006442:Glycated Hemoglobin; D006397:Hematinics; D011188:Potassium; D011994:Recombinant Proteins