Diabetes and Anemia
Most people have actually become aware of anemia and know that it has something to do with the blood. Many people also associate anemia with sensation tired. However most likely not too many people could discuss precisely what anemia is.
Mentioned simply, anemia is a condition where there is a lower than normal variety of healthy red blood cells in the body and/or a lower than normal amount of hemoglobin at a loss blood cells.
Red cell bring oxygen from your lungs to the rest of your body. The specific part of the red cell that carries oxygen is called hemoglobin. Red cell also carry waste products from the cells to the urinary and breathing systems to be excreted. When either the number of red cell or the amount of hemoglobin is low, the body’s cells get less oxygen than normal. A low oxygen level can cause fatigue and other symptoms such as weak point, problem exercising, and light-headedness.
Anemia can establish for lots of reasons. In reality, there are more than 400 types of anemia. But they can all be categorized into these 3 basic groups:
- Anemia brought on by the loss of blood
- Anemia triggered by a decrease in red cell production in the bone marrow or impaired production of red blood cells
- Anemia brought on by red cell destruction
Anemia is a relatively typical condition, but it often goes unacknowledged and therefore not dealt with. Its symptoms are vague and quickly mistaken for symptoms of other serious or chronic diseases. But even moderate anemia can significantly decrease one’s quality of life, and without treatment anemia can have major long-lasting health results.
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Does Diabetes Cause Anemia?
Diabetes does not directly cause anemia, but particular complications and conditions related to diabetes can contribute to it. For example, both diabetes-related kidney disease (nephropathy) and nerve damage (neuropathy) can add to the development of anemia. In addition, taking certain oral diabetes drugs can raise the risk of developing anemia. People with diabetes can likewise have anemia as a result of not consuming well or of having a condition that hinders the absorption of nutrients.
Kidney disease. Typically, the kidneys secrete a hormone called erythropoietin, which stimulates the bone marrow to produce red cell. In diabetic nephropathy, the tiny capillary that filter waste items from the body ended up being broken and begin “leaking” substances (such as protein) into the urine. At the exact same time, the amount of erythropoietin produced by the kidneys is lowered, resulting in anemia. Some research studies have shown that decreased erythropoietin production and anemia occur previously in people with diabetes and kidney disease than in those with kidney disease and no diabetes.
Both chronically high blood sugar levels and hypertension can cause kidney damage.
Neuropathy. In people who have a type of neuropathy called autonomic neuropathy, the body may not have the ability to correctly signify the kidneys to produce more erythropoietin in response to anemia.
Heart failure. People who have diabetes are at increased risk for heart failure, or the inability of the heart to pump adequate blood to fulfill the body’s requirements. Reduced heart function can cause kidney dysfunction, and lots of people with heart failure also have dietary shortages; both of these can contribute to anemia. About 20% of individuals with heart failure are anemic.
Nutrient deficiencies. Lots of people who have diabetes have nutrient shortages that can cause anemia. Nutrient shortages can be brought on by either not eating enough nutrients (because an individual restricts his food options, for example) or by the body’s inability to absorb the nutrients that are consumed. Deficiencies in iron, vitamin B12, vitamin B6, and folate can all cause anemia.
One condition that impacts the body’s ability to take in nutrients is celiac disease. In celiac disease, the body can not tolerate gluten, a protein discovered in wheat, barley, and rye. If gluten is eaten, the normal, fingerlike folds of the small intestine flatten out, avoiding the absorption of not just the gluten but of other nutrients, as well. About one in 20 individuals who have diabetes likewise have celiac disease.
Bariatric (weight-loss) surgery can likewise cause nutrition deficiencies that cause anemia. Vitamin and mineral supplements are usually needed after bariatric surgery to avoid this.
Diabetes drugs. Metformin is one of the most commonly prescribed treatment for individuals with Type 2 diabetes. It is now acknowledged that metformin can cause malabsorption of vitamin B12 and that long-lasting use (12 — 15 years) of metformin leads to vitamin B12 deficiency in 30% of people who use it. Vitamin B12 deficiency can cause anemia as well as peripheral neuropathy (nerve damage in the feet, legs, hands, and arms).
Another kind of diabetes drug, the thiazolidinediones, that include pioglitazone (Actos) and rosiglitazone (Avandia), can likewise cause moderate anemia by a little reducing hemoglobin levels and hematocrit, a measurement of the percentage of blood that is made up of red cell.
Symptoms
An individual with very moderate anemia may have no symptoms, however more serious anemia can cause exhaustion, weak point, dizziness, irritation, shortness of breath, and/or depression. It can likewise cause breakable nails; pale skin; cold hands and feet; numbness and/or tingling in the fingers, toes, and feet; chest pain; an irregular heart beat; cravings to eat uncommon things such as ice; problem concentrating; and sexual problems.
If you have these symptoms, ask your health-care provider to inspect to see if you are anemic.
Detecting anemia
Anemia is diagnosed with a blood test. The blood sample is analyzed for the quantity of hemoglobin in the blood and for the hematocrit.
For men, the normal hemoglobin variety is 13.8 — 17.2 grams per deciliter (g/dl), and the normal hematocrit is 40.7% to 50.3%.
For women who are not pregnant, the normal hemoglobin range is 12.1 — 15.1 gm/dl, and the normal hematocrit is 36.1% to 44.3%.
The normal varieties for both men and women may differ somewhat from one laboratory to another and also vary according to elevation. At higher elevations, the body produces more red blood cells in action to the decreased oxygen readily available. A higher number of red blood cells means that hemoglobin levels and hematocrit are likewise increased.
See also: All about the Hemoglobin A1C Test
Test results listed below the low end of the normal range for either hemoglobin or hematocrit can show anemia. If initial tests show anemia, more blood tests might be done to establish the cause of the anemia and the best method to treatment. For example, a test for the level of iron in the blood is typically done, given that iron shortage is the most common reason for anemia. Other diagnostic tools consist of a health examination and asking about such things as family history of anemia, diet, use of prescription or non-prescription drugs, heavy menstrual bleeding (in premenopausal women), and any signs of internal bleeding, such as blood in stools.
As a side note, blood glucose meters have a hematocrit range at which they offer accurate results. Having a hematocrit that falls outdoors your meter’s range may mean you are getting unreliable outcomes when monitoring your blood sugar. The package insert that included your meter needs to state its hematocrit range.
Treatment and avoidance
The treatment for anemia depends upon the cause and intensity of it. For example, if anemia is due to blood loss and it’s not severe, determining the source of bleeding and stopping it will typically suffice to reverse the anemia. For other causes or more major cases, other actions might have to be taken, such as dealing with an underlying disease, taking vitamin or mineral supplements, and making dietary modifications.
In all cases, it requires time for the body to develop brand-new, healthy red cell, so a person is likely to feel better gradually.
Since anemia can recur, depending on the cause, the steps taken to treat it might need to be continued — potentially for life — to prevent it from coming back.
Kidney disease. If you have kidney problems, you need to be under the care of a nephrologist, a physician who focuses on kidney diseases. Treatment for anemia associated to kidney disease may consist of both actions to reverse the anemia and steps to improve kidney function (or avoid it from aggravating). For example, to reverse the anemia, injections of a type of drug called an erythropoiesis-stimulating agent may be prescribed to promote your bone marrow to produce red cell. In addition, drug therapy with specific types of blood pressure drugs might be recommended to avoid further kidney damage.
Also crucial for avoiding additional kidney damage are obtaining and keeping blood glucose levels as near to normal as possible and a blood pressure level listed below 130/80 mm Hg. If your kidney damage is already severe, however, you might require dialysis or a kidney transplant.
No matter how severe your kidney disease, you ought to meet with a registered dietitian who specializes in kidney diseases to assist you with your food choices. Individuals with diabetes and kidney disease have dietary needs that are somewhat various from those of individuals who have diabetes and no kidney disease. In specific, they require personalized guidelines for protein, potassium, phosphorus, and fluid consumption, as well as for carbohydrate intake.
Heart failure. Take your medications as recommended, and follow your healthy lifestyle plan. Weigh yourself every morning, and report a weight gain of 3 pounds in one day or 5 pounds in one week to your health-care team. Rapid weight gain such as this can suggest that your heart function is worsening, and fluid is collecting someplace in your body.
Diabetes drugs. If you take either metformin or a thiazolidinedione (Actos or Avandia), ask your health-care provider to check your blood to see if you are anemic. If your laboratory results show a low vitamin B12 level, you may be prescribed B12 supplementation. If your hematocrit and hemoglobin are low, your dosage of Actos or Avandia may decreased, you might be recommended to eat more foods that are higher in iron, and/or you might be advised to begin taking iron supplements.
Nutrient shortages. If your anemia is due to blood loss or a nutrient shortage, you might be advised to eat more iron-rich foods and potentially to take iron supplements.
Iron-rich foods consist of beef, organ meats, pork, poultry, fish, clams, and oysters. The iron in foods of animal origin such as these is normally quickly absorbed by the body. The iron in plant foods, such as fruits, vegetables, dried beans, nuts, and grain items, is less easily soaked up, but absorption can be increased by eating these foods in addition to foods high in vitamin C, such as dark leafy greens, broccoli, bell peppers (especially red, yellow, and orange peppers), tomatoes, mangoes, papayas, and kiwifruits.
Taking vitamin C supplements is another choice for helping your body absorb iron. Nevertheless, vitamin C supplements can affect the accuracy of some blood glucose meters. Before you take vitamin C supplements, ask your meter’s maker if taking vitamin C (also called ascorbic acid) impacts the performance of your meter.
If your nutrient shortage is because of a lack of vitamins or minerals aside from iron, such as folate or vitamin B12, you may be recommended a supplement, and you will be encouraged to eat foods high in folate and B12.
Foods high in folate include green leafy vegetables, eggs, seafood, lean beef, organ meats, orange juice, dry beans, lentils, asparagus, and broccoli.
Foods high in vitamin B12 consist of all animal products, including eggs, dairy products, and meat. Individuals who follow a vegan diet are at risk of vitamin B12 deficiency and ought to take a vitamin B12 supplement.
If your nutrient shortage is found to be a consequence of having celiac disease, you will have to follow a strictly gluten-free diet for the rest of your life to allow your small intestine to heal and remain healthy.
Anyone identified with a nutrient deficiency ought to consult with a signed up dietitian or nutritionist to talk about healthy food choices and how to avoid such a deficiency from happening again. Meeting a dietitian may be especially useful for people detected with celiac disease, considering that switching to a gluten-free diet can be a difficulty.
Feeling much better
As lots of as 25% of Americans with diabetes likewise have anemia, so if you feel tired or weak, get it checked out. Don’t diagnose yourself with anemia, however. There are many factors you might feel exhausted and weak, and trying to treat yourself for anemia when you don’t have it could create or aggravate other issues.
If your doctor does detect you with anemia and prescribes a treatment, you need to get routine blood tests to track your progress. In time you should observe that you feel far better.
