Frequency of iron deficiency anemia in type 2 diabetes - Insights from tertiary diabetes care centres across India

Type 2 Diabetes Mellitus and Helicobacter pylori Gastritis in Patients Referred for Endoscopy-A Single-Center Romanian Study

BACKGROUND

Type 2 diabetes mellitus (T2DM) affects up to 10% of adults globally, and its complications can mask the risk of gastrointestinal bleeding or malignancy.

METHODS

Our study enrolled 633 endoscopic patients stratified according to T2DM presence (4:1 ratio in favor of the control group).

RESULTS

T2DM patients referred for endoscopy experienced lower prevalence of epigastric pain and heartburn (OR = 0.637/OR = 0.346, p < 0.05). Often being anemic (OR = 2.23, p < 0.001), they had significantly lower hemoglobin (p = 0.001) and serum iron (p = 0.02), but serum cholesterol was higher in non-diabetics. Ulcers, erosions and mucosal hemorrhages were comparable between groups (p < 0.05), although low-dose aspirin use was more prevalent in diabetics (p = 0.000, OR = 2.34). T2DM was associated with the increased frequency of antro-corporal active gastritis (OR = 1.451/OR 1.501), with smokers presenting a higher frequency of active H. pylori infection (OR = 3.37). T2DM predicted anemia (adjusted OR = 1.70) and the absence of gastroesophageal reflux symptoms (adjusted OR = 0.37), but not active H. pylori gastritis or premalignant lesions.

CONCLUSION

In an endoscopic population, patients with T2DM had lower hemoglobin and serum iron levels. There was an inverse correlation between T2DM and heartburn. H. pylori gastritis and premalignant lesions occurred more frequently in diabetic patients (predominantly pangastritis) before adjusting for age or associated comorbidities, with smoking increasing the risk for active infection.

A Mutagen Acts as a Potent Reducing Agent of Glycated Hemoglobin: a Combined Ultrafast Electron Transfer and Computational Studies

Glycated hemoglobin (GHb) found in mammals undergoes irreversible damage when exposed to external redox agents, which is much more vulnerable than its normal counterpart hemoglobin (Hb). Besides the oxygen regulation throughout the body, Hb plays a vital role in balancing immunological health and the redox cycle. Photoinduced ultra-fast electron transfer phenomena actively participate in regulation of various kind of homeostasis involved in such biomacromolecules. In the present study we have shown that a well-known mutagen Ethidium Bromide (EtBr) reduces GHb in femtosecond time scale (efficiently) upon photoexcitation after efficient recognition in the biomolecule. We have performed similar experiment by colocalizing EtBr and Iron (Fe(III)) on the micellar surface as Hb mimic in order to study the excited state EtBr dynamics to rationalize the time scale obtained from EtBr in GHb and Hb. While other experimental techniques including Dynamic Light Scattering (DLS), Zeta potential, absorbance and emission spectroscopy have been employed for the confirmation of structural perturbation of GHb compared to Hb, a detailed computational studies involving molecular docking and density functional theory (DFT) have been employed for the explanation of the experimental observations.

Global Prevalence of Anemia Among Type 2 Diabetic Adult Patients: A Systematic Review and Meta-Analysis

Background

Anemia is a common and often overlooked hematological change observed in patients with diabetes mellitus. However, there is no global survey or health registry that estimates the pooled prevalence of anemia in patients with type 2 diabetes. Therefore, this study aimed to determine the global pooled prevalence of anemia among adult patients with type 2 diabetes.

Methods

This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The study protocol was registered on PROSPERO with the reference number (CRD42022327135), and the link provided (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022327135) display the published methodology. Previously published articles were searched in PubMed/Medline, Cochrane Library, WHO Global Index Medicus, African Journals Online, ScienceDirect, Google Scholar, and Google from October 26 to November 09, 2022. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal tool. Random-effects model was used to estimate the pooled prevalence of anemia. The degree of heterogeneity among the included studies was assessed using I2 statistics. Publication bias was detected using funnel plot symmetry analysis supplemented by Egger's and Begg's tests.

Results

Twenty-four studies with a total number of 19,118 participants were included in this systematic review and meta-analysis. The overall pooled prevalence of anemia among type 2 diabetic adult patients was 27.0% (95% CI: 24.0, 31.0, I2 = 96.45%; P< 0.001). Geographical and time-based subgroup analysis showed that higher prevalence of anemia was observed in Africa region 28.0% (95% CI: 17.0, 39.0) and from 2015 to 2022, 28.0% (95% CI: 24.0, 33.0), respectively.

Conclusion

Anemia is a moderate public health problem among adult patients with type 2 diabetes. Nearly one in four patients with type 2 diabetes develops anemia. Therefore, considering the negative impact of anemia, it is important to include anemia screening in the routine assessment of diabetes-related complications.