Anaemia in Type 2 Diabetes Mellitus (T2DM) Patients in Hospital Putrajaya
- Author:
Subashini Chellappah Thambiah
;
Intan Nureslyna Samsudin
;
Elizabeth George
;
Lydiar Kaur Ranjit
;
Nur Syakila Saat
;
Zanariah Hussein
;
Nurain Mohd Noor
;
Masni Mohamad
- Publication Type:Journal Article
- Keywords:
Anaemia;
Type 2 diabetes mellitus (T2DM);
Chronic kidney disease (CKD);
Diabetic
- MeSH:
Diabetes Mellitus, Type 2
- From:Malaysian Journal of Medicine and Health Sciences
2015;11(1):49-62
- CountryMalaysia
- Language:English
-
Abstract:
Patients with diabetes have an earlier onset and increased severity of anaemia compared to those with
similar degree of renal impairment from other causes. Anaemia is associated with an increased risk
of vascular complications. In this study, we determined the prevalence of anaemia in T2DM patients
and its association with sociodemographic, clinical and laboratory parameters in an endocrine tertiary
hospital in Malaysia. This was a cross-sectional study using retrospective electronic data from January
2011 to December 2013 of 165 T2DM patients in Hospital Putrajaya. Data was analysed using IBM
SPSS Statistics version 21.0 for Windows. The prevalence of anaemia was 39.4% and majority had
normocytic normochromic (80%), mild (58.5%) anaemia. Majority were Malays (73.9%), aged below
60 with comparable gender percentage and long-standing, poorly-controlled DM [median fasting blood
sugar (FBS) 8mmol/L; glycated haemoglobin (HbA1c) 7.9%]. Using the KDIGO chronic kidney disease
(CKD) staging system, 86% of these patients were in stages 3-5. Anaemic patients had a significantly
higher serum urea, creatinine and a lower FBS, estimated glomerular filtration rate (eGFR) compared to
non-anaemic patients. Anaemic patients with diabetic nephropathy had a significantly lower haemoglobin
(Hb) compared to those without this complication (p=0.022). The sensitivity and specificity at a cut-off
eGFR value of 38.3 ml/min/1.73 m2 (maximum Youden index = 0.462) was 66.7% and 79.5%, respectively
to discriminate mild from moderate anaemia. This study shows that anaemia is already present in T2DM
patients in Hospital Putrajaya at initial presentation to the specialist outpatient clinic and is significantly
associated with CKD. Hence, it emphasises the obligatory need for routine and follow-up full blood
count monitoring in T2DM patients in primary care as well as tertiary settings in Malaysia to enable
early detection and aggressive correction of anaemia in preventing further complications.
- Full text:P020150604453628414320.pdf
