Diabetes & Obesity International Journal (DOIJ)

ISSN: 2574-7770

Review Article

Anaemia and Erythropoietic Stress in Diabetes Mellitus

Authors: Bhavana U*, Vaishnavi P#, Merin Livingston, Priyanka T and Reynaa Mary N

DOI: 10.23880/doij-16000289

Abstract

Patients with diabetes get anaemia more frequently than those without the disease, and the issue is worse in those who have impaired renal function. Patients with diabetes who also have anaemia may be more vulnerable to the negative effects of diabetic retinopathy, nephropathy, neuropathy, and cardiovascular disease. In addition to kidney failure, the multifactorial aetiology of anaemia in diabetes includes inflammation, nutritional inadequacies, concurrent autoimmune disorders, medications, and hormonal abnormalities. For those with nephropathy or heart failure, anaemia linked to erythropoietin insufficiency may have prognostic implications. Anaemia and erythropoietin insufficiency may arise from injury to the peritubular fibroblasts in early diabetic nephropathy, before filtration loss occurs. Chronic hyperglycemia caused by diabetes may result in a hypoxic environment in the renal interstitium, which lowers erythropoietin synthesis by peritubular fibroblasts and causes anaemia. In individuals with diabetes mellitus, anaemia may exacerbate diabetic retinopathy and nephropathy as well as have a role in the aetiology and development of cardiovascular disease. Compared to people without diabetes who have chronic kidney disease, persons with diabetic renal disease experience anaemia earlier. The ideal target haemoglobin level is still up for debate, despite the fact that erythropoietin has been used to treat renal anaemia for almost 20 years. According to the majority of guidelines, haemoglobin levels should be kept between 105 and 125 g/l. It is still unknown how correcting anaemia may help people with diabetes mellitus avoid developing left ventricular hypertrophy. In addition to screening for other diabetes-related issues, regular anaemia screening may help these patients' vascular difficulties from progressing more slowly. Retinopathy, diabetic nephropathy, postural hypotension from autonomic neuropathy, and other microvascular and macrovascular problems are all thought to be slowed down in their progression by treating anaemia.

Keywords: Diabetes Mellitus; Kidney Disease; Erythropoietic Stress; Anaemia

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