Hemoglobin concentrations are closely linked to renal function in patients with type 1 or 2 diabetes mellitus.
OBJECTIVE
It has been reported that anemia is more common in patients with diabetes mellitus, and that it occurs early in the disease process.


METHODS
In this study, we evaluated hemoglobin (Hb) values of patients with diabetes type 1 or 2 from a large collective receiving care from a tertiary center. A total of 751 patients with type 1 diabetes and 3,306 patients with type 2 were studied. Correlations were calculated for Hb with the following parameters: metabolic control (HbA(1c) and blood glucose), renal function [estimated glomerular filtration rate (eGFR), serum creatinine, albuminuria, proteinuria], blood leukocytes, duration of diabetes and use of ACE inhibitors/AT1-receptor antagonists.


RESULTS
17% of patients with type 1 diabetes and 14% of those with type 2 had anemia [defined as an Hb <8.5 mmol/l (<13.68 g/dl) in men and <7.5 mmol/l (<12.07 g/dl) in women). There was a close positive correlation between Hb and eGFR, and a negative correlation with albuminuria and proteinuria. These close associations were also confirmed with linear regression analysis. A significant negative correlation was observed between serum creatinine levels and Hb. There was no negative correlation between actual Hb and mean HbA(1c) in the individual follow-up periods. No correlation was found between blood glucose (morning and postprandial blood glucose) and Hb. Blood leukocyte numbers, as a parameter of systemic inflammation, were not correlated with Hb. The use of ACE inhibitors/AT1-receptor antagonists had no adverse effect on Hb in our study cohort.


CONCLUSIONS
No negative effects of metabolic control on Hb could be demonstrated in this study.
Wolf
Gunter
G
Klinik für Innere Medizin III, Klinikum der Friedrich-Schiller-Universität, Jena, Germany. Gunter.Wolf@med.uni-jena.de
Müller
Nicolle
N
Hunger-Battefeld
Wilgard
W
Kloos
Christof
C
Müller
Ulrich A
UA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D055815:Young Adult
D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D006454:Hemoglobins