Evaluation of Anaemia in Type 2 Diabetes Mellitus Patients with Special Reference to Vitamin B12 Deficiency

Background: Anemia is prevalent in patients with diabetes. It predicts the progression of diabetic complications. 1Vitamin B12 deficiency is also a potential comorbidity in diabetes mellitus. 2 The aim of this study was to evaluate anaemia in patients with type 2 diabetes mellitus with normal renal function with special reference to vitamin B12 deficiency. Methods: This study was an observational study conducted where 190 cases greater than 13 years of age with type 2 diabetes mellitus having eGFR greater than60 ml/min; serum creatinine less than 1.5 mg/dl; urine albumin to creatinine ratio less than 300 mg/g were selected. Anaemia was defined using World Health Organization criteria: haemoglobin less than13 g/dl for men, less than12 g/dl for women. Vitamin B12 estimation was done by the principle of ELISA. The statistical significance was fixed at 5% level (p value less than0.05). Results: The prevalence of anaemia in type 2 diabetics with normal renal function was 36.32% with male to female ratio 0.7: 1 and mean age 56.11?18.75 years with major type being normocytic Duration of diabetes, daily metformin dosegreater than1000mg, duration of metformin use greater than5 years, hypertension, dyslipidemia, poor glycemic control, microalbuminuria were found to be statistically significant risk factors. The prevalence of diabetic complications was higher in patients with anaemia. The prevalence of Vitamin B12 deficiency was 17.36% being an independent risk factor for anaemia. (p=0.113; OR=1.9). Conclusion: Anaemia is prevalent in type 2 diabetics even before the onset of renal impairment with higher prevalence of complications (microvascular mainly studied here) which increased with increasing severity of anaemia. Vitamin B12 deficiency is prevalent in diabetics with anaemia.