ECE2023 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (355 abstracts)
Biermer anemia in a type 2 diabetic not treated with Metformin
Elleuch Mouna , Wissal Ghamgui , Hadj Kacem Faten , Maalej Souhir , Mnif Mouna , Mnif Fatma , Charfi Nadia , Rekik Nabila & Abid Mohamed
Endocrinology and Diabetology Service, CHU Hedi Chaker, University of Sfax, Sfax, Tunisia.
Introduction: Anemia is defined by the World Health Organization as a hemoglobin concentration less than 120 g/l in women outside of pregnancy, and less than 130 g/l in men over 15 years of age. It is common in diabetics. It can be due to an autoimmune disease associated with type 1 diabetes, whereas the inflammatory cause is the primary cause in type 2 diabetes.
Observation: This is a 75 year old patient, type 2 diabetic for 21 years on insulin analogues without metformin; He presented with diabetic nephropathy and coronary insufficiency. In July 2022, the patient presented intense asthenia with anorexia and severe hypoglycemia of 0.3 g/l. In this context, a blood cell count was done showing anemia of 90 g/l with a mean blood volume of 109 fl. The etiological investigation confirmed a hypovitaminosis B12 with a normal folate level. The antiintrinsic factor antibodies were strongly positive. The diagnosis of Biermer anemia was retained and the patient was put on vitamin supplementation. Clinical and biological improvement and disappearance of hypoglycemia (assessment after one month of of vitamin B12 supplementation: hemoglobin 110 g/l with VGM 97 fl) were observed in our patient.
Conclusion: Beyond the search for a cause in order to ensure its treatment, the discovery of anemia in diabetic patients must systematically raise the question of its influence on glycemic control and the interpretation of glycated hemoglobin tests.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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