Many people living with diabetes struggle with low red blood cells (anemia).
But how are the two conditions related?
Does one condition cause another?
And should you bring iron supplements to help?
In this article, we will investigate the relationship between diabetes and anemia. We also cover what you need to know about iron supplements if you are struggling with this condition.
What is anemia?
According to the National Heart, Lung, and the Blood Institute, anemia occurs when the body’s blood does not have enough red blood cells to function properly. This reduces the oxygen flow to the organs.
Sometimes the disease is symptomatic and is often not diagnosed.
It is a very common condition. More than 3 million new cases are diagnosed each year in the United States.
Anemia can have many causes, including:
- Unintentional blood loss
- Lack of red blood cell production
- High rate of red blood cell destruction
Related conditions that can cause anemia include severe periods, pregnancy and, in some cases, diabetes.
What are the symptoms of anemia?
Symptoms of anemia vary, and may include:
- Pale skin
- Rapid pulse/heart rate
- Fatigue
- shortness of breath
- Hypothermia
- Dizziness
- Lighthead
- headache
- Cold limbs (hands and feet)
If you have diabetes and have any of these symptoms, you should check your blood glucose levels frequently.
This is to ensure that you can’t mistake anemia with hypoglycemia or hyperglycemia levels.
Call your doctor and ask about testing for anemia if you’ve been suffering from these symptoms for a few weeks without normal blood sugar and ketones.
You can see Christel Oerum, a type 1 diabetes, speak about how she successfully handled it in this short video.
Diabetes does not cause anemia, and anemia does not cause diabetes.
However, two conditions are related. However, having one condition does not lead to the development of other conditions.
Research shows that up to one in four diabetics are anemia and often undiagnosed.
Anemia is particularly common in people with type 2 diabetes who suffer from diabetic complications (CKDs), such as renal dysfunction and chronic kidney disease.
This is common because the damaged or failed kidneys do not produce a hormone called erythropoietin (EPO).
EPO signals the bone marrow that the body needs more red blood cells to function. And anemia is simply due to the low number of these healthy red blood cells.
In the presence of diabetes, the early stages of kidney disease and dysfunction are often asymptomatic.
However, if you are diagnosed with anemia and live with diabetes, it is best to have your kidney function checked as many patients with diabetes and kidney problems develop anemia.
Diabetes also causes inflammation of the blood vessels. This prevents the bone marrow from receiving hormonal EPO signals and even creating more blood cells. There is a greater chance that anemia will occur.
On the other hand, if you are diagnosed with diabetes after suffering from anemia, it may contribute to the development of complications.
These include retinopathy and eye and nerve damage (neuropathy).
If you are anemia and lack healthy red blood cells, your arteries, heart and kidney health can deteriorate. These organs are already at risk when someone has diabetes.
Is diabetes and anemia dangerous?
Having two conditions means there is more to manage. However, anemia can affect blood glucose levels.
A 2010 study found that anemia produces false hyperglycemia levels in household glucometers.
This led to a patient’s dangerous hypoglycemia (hypoglycemia) episode (due to an overdose of insulin due to false hyperglycemia).
This is extremely dangerous for diabetics.
Alternatively, there is a direct link between anemia caused by iron deficiency and the high amount of glucose in the blood.
In 2017, several studies found that iron deficiency anemia was correlated with increased HBA1C levels in people with or without diabetes.
This happened naturally. This is because more glucose molecules make fewer red blood cells.
After iron replacement therapy, the patients’ HBA1C levels decreased and returned to normal.
Can my diabetes medication cause anemia?
Insulin does not cause anemia.
However, there are other diabetes medications that can contribute to the development of anemia.
These include metformin, fibrate, thiazolidinedione, and ACE inhibitors. This can drop the human protein hemoglobin, which is important to carry oxygen throughout the bloodstream.
Taking any of these drugs may increase your risk of developing anemia. Contact your doctor if you are worried.
Metformin can be particularly bothering you. This is because it can cause malabsorption of vitamin B12.
Long-term use of drugs can lead to vitamin B12 deficiency. This can cause anemia.
Studies have shown that there is a strong correlation between metformin use and megalithoblast anemia.
Therefore, if you have diabetes and are taking metformin for a long time, you should request a regularly drawn blood panel (called CBC or full blood count).
Blood loss is also a major cause of anemia, so if you have diabetes and are undergoing renal dialysis, consult your doctor about an increased risk of anemia.
How is anemia treated?
Depending on the underlying cause, treatment for anemia is very simple.
Anemia caused by iron deficiency can be improved by taking oral iron supplements.
You can choose to eat more iron-rich foods, such as:
- Legumes
- Lentils
- beans
- Green leaf vegetables
- Tofu
- Lean meat
- fish
- liver
- oyster
- Prunes and raisins
If you are taking metformin and suffering from anemia, we recommend replacing diabetic medications for an alternative or talking to your doctor about tapering the metformin dose.
If you have undergone kidney dialysis treatment, choose to have your doctor absorb iron directly. For many patients, this increases hemoglobin well.
However, it can also increase the risk of both heart attacks and strokes.
If your kidneys are damaged and you are not producing enough hormone EPO, you may be prescribed a synthetic hormone (RHEPO) to promote red blood cell production.
However, between 5-10% of patients receiving RHEPO therapy, there is resistance to this therapy.
If you receive this treatment, your doctor should closely monitor you.
Finally, in severe cases, a blood transfusion may be required.
Conclusion
Diabetes does not cause anemia and anemia does not cause diabetes, but the two conditions are closely related.
Diabetic complications such as kidney disease and inflamed blood vessels can contribute to the development of anemia.
This is because the levels of the hormone erythropoietin (EPO) produced in the body are low.
This hormone usually tells the bone marrow that the body needs to produce more red blood cells.
However, EPO does not provide a signal and red blood cell levels decrease.
Inflammation of blood vessels prevents the bone marrow from receiving EPO signals, and anemia is also more likely.
Furthermore, some drugs such as fibrates, ACE inhibitors, thiazolidinediones, and especially metformin, can contribute to the development of anemia.
If you are using metformin for a long period of time, consider refilling your diet with B12 or iron.
If you have anemia, you may find it difficult to manage diabetes.
A lack of healthy red blood cells can exacerbate diabetes complications, including kidneys, eyes, nerves, arteries and heart health.
You may also struggle with persistently high blood sugar and HBA1C levels.
However, anemia can be treated.
You can choose to change or add dietary or supplements.
You may also need to change your diabetes medication or have a blood transfusion.
If you are worried about developing anemia or have recently been diagnosed with a condition, consult your doctor.
