Anitha, A (2020) A Study of Prevalence of Anaemia among Patients with Type 2 Diabetes Mellitus and Its Prognostic Significance in a Tertiary Care Centre Coimbatore. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
BACKGROUND: Diabetes mellitus (DM) is a metabolic disorder of great impact worldwide. Diabetes is a highly disabling disease, which can cause major complications in our body in the form of retinopathy, nephropathy, anemia, cardiovascular and brain complications. Anemia in patients with diabetes is of great concern and it must be treated once diagnosed, since it may contribute to the pathogenesis and progression of cardiovascular disease, hypertension and various other complications with significant adverse effect on quality of life. Therefore it is important to diagnose and treat anaemia in diabetes mellitus patients. AIM OF THE STUDY: 1. To find the prevalance of anemia in a sample of type 2 diabetic mellitus patients. 2. To establish the prognostic significance of anemia in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: This is a prospective study of 200 cases of type 2 diabetes mellitus in the diabetology ward and medical ward of Coimbatore Medical College Hospital,Coimbatore for a period of one year.All patients above 18 years age of both genders and patients with type 2 diabetes mellitus who are on antidiabetic drugs for atleast 6 months are included in this study. Patients less than 18 years of age, anemia due to chronic blood loss and other secondary causes, patients taking drugs for diseases like anticancer drugs, antiplatelet drugs causing anaemia and Diabetes mellitus patients with renal failure in the form of microalbuminuria, macroalbuminuria and kidney injury and the patients who did not give consent are excluded from this study. RESULTS: In this study 200 patients of diabetes mellitus were studied and the prevalence of anaemia and its prognostic significance are studied. The various parameters like Random blood sugar, fasting blood sugar,postprandial blood sugar, complete haemogram, peripheral smear, Renal function test, liver function test, Serum LDH, Reticulocyte count, USG abdomen, Stool ova cyst, stool occult blood in diabetic patients are studied and compared in this study. In this study none of the patients had altered renal parameters. In about 200 patients, 73 were male(36.5%) and 127 were female (63.5%). About 63.5% females are anaemic in our study. It was found that in the age group of 41 -50 years, more number of patients have DM. Here about 64% of the patients had HBA1C values >10% and 36% of the patients had HBA1C values of 7-10%. In this study we compared the peripheral smear of the diabetic patients, and was found to have 42.5% had Dimorphic anaemia, 36.5% had microcytic hypochromic anaemia and 21% had megaloblastic anaemia. About 17% of the patients had < 5 years of diabetes, 48.5% of the patients had 5 – 10 years of diabetes and 34.5% of the patients had > 15 years of diabetes. About 55.5% had CAD and 57.5% had SHT comorbidities. SUMMARY: In this study the incidence of anaemia is more in females when compared to males. Dimorphic anaemia was found to be more prevalent in our study about 42.5% followed by Microcytic hypochromic anaemia of 36.5%, followed by Megaloblastic anaemia in 21%. In this study the prevalence of Systemic hypertension (57.5%) and Coronary artery disease(55.5%) in diabetic patients who were anemic was significantly higher. This association is of concern considering that hypertension and CAD in diabetes increases the risk of micro and macrovascular complications of diabetes mellitus. In this study, the prevalence of anaemia increases with increasing duration of disease of Diabetes Mellitus. Poor control of diabetes with high HBA1C will have low haemoglobin levels leading to anaemia. In this study patients who had taken oral hypoglycaemic agents for treatment were found to be more anaemic when compared to those who had insulin for DM. Elderly diabetics are more prone for anaemia, microvascular and macrovascular complications of diabetes in this study. CONCLUSION: Anaemia is one of the most common preventable conditions especially in diabetes mellitus. This study concludes that the need for periodic hematological screening in all diabetic patients presenting to hospital and adequate cost effective remedial measures in the form of supplementation of iron and vitamins will result in better outcome and prognosis and prevention of major complications.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201711303 |
| Uncontrolled Keywords: | Anaemia, Type 2 Diabetes Mellitus, HBA1C, Oral hypoglycaemic agents, Insulin,Coronary artery disease, Systemic hypertension. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Jan 2021 18:13 |
| Last Modified: | 29 Jan 2021 02:28 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13298 |
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