ECE2021 Audio Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (223 abstracts)
1Tel-Aviv University, Sackler Faculty of Medicine, Tel-Aviv, Israel; 2Meir Medical Center, Internal Medicne D, Kefar Sava, Israel; 3Meir Medical Center, internal Medicine A, Kefar Sava, Israel; 4Clalit Health Services, Tel Aviv-Yafo, Israel; 5The Academic College of Tel AvivYaffo, Tel Aviv-Yafo, Israel; 6Meir Medical Center, Hematology, Kefar Sava, Israel; 7Meir Medical Center, Endocrinology, Kefar Sava, Israel
Background
Although anemia was previously described as a complication of diabetes mellitus (DM), its prevalence and prognostic meaning in patients with DM and pre-DM with normal kidney function was not thoroughly investigated.
Methods
A retrospective analysis of patients with DM and pre-DM referred to the endocrine institute in Meir medical center during 2015. Patients with estimated glomerular filtration rate (eGFR) < 60 ml/min or any other recognized cause of anemia were excluded. Four-years outcome was assessed including development of microvascular complications, macrovascular complications and mortality.
Results
A total of 622 patients (408 with DM and 214 pre-DM) were included. Their mean age was 64 ± 10.6 years, and 69% women. Baseline HbA1 c was 7.1 ± 1.7% and eGFR was 86.1 ± 15.3 ml/min. The prevalence of anemia was 19% in DM and 11% in pre-DM. Multivariable analysis adjusting for several clinical and laboratory parameters demonstrated a negative correlation between baseline hemoglobin level (as a continuous variable) and mortality (P = 0.035), microvascular complications (P = 0.003) and eGFR decline (P < 0.001), but not with macrovascular complications(P = 0.567).
Conclusions
Our study demonstrates a significant prevalence of anemia unrelated to renal failure, both in DM and pre-DM and its association with development of microvascular complications, eGFR decline and mortality. These results underscore the need for intensive lifestyle and pharmacological intervention in pattients with DM or pre-DM and anemia.