A study of functional erythropoietin deficiency in patients with type-2 diabetes and anemia

 Anemia is a common finding in diabetes, particularly in patients with diabetic nephropathy or renal impairment. This study was designed to assess the prevalence of functional erythropoietin deficiency in patients with type-2 diabetes and anemia. In a hospital based observational descriptive study, 60 diagnosed diabetic patients were included. They were divided into 2 groups: group I had diabetic patients without anemia with/without diabetic nephropathy and group II had type 2 diabetics with anemia with/without diabetic nephropathy. Most of the subjects (50%) in group I without diabetic nephropathy had their serum erythropoietin levels in the range of 15-30 IU/L with a mean value of 19.01± 2.11 IU/L. All the subjects in group I who had diabetic nephropathy had their serum EPO levels between 15-30 IU/L with a mean value 24.17±3.03 IU/L. In group II with diabetic nephropathy, most of the subjects (72.5%) had their serum EPO value <15 IU/L with a mean value of 10.45± 1.61 IU/L and all the subjects without diabetic nephropathy had their serum EPO level above 30 IU/L with mean value 36.41±3.0 IU/L. Comparison of both groups showed highly significant difference in EPO levels statistically (P<0.001). This study suggest further researches to find out relation of functional erythropoietin deficiency with a pattern of damage to the renal tubulointerstitium and microvasculature in diabetic kidney restricting the production of erythropoietin to maintain red cell mass in response to tissue hypoxia or a defect of "Anemia sensing" mechanism.