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Year : 2013  |  Volume : 2  |  Issue : 1  |  Page : 32-36

Type 2 Diabetes Mellitus is causing red blood cell hemolysis

Hematology Unit, Teaching Laboratories Department, Al-Yarmouk Teaching Hospital, Address correspondences to Dr. Zainab Mohammed Hasan

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Source of Support: None, Conflict of Interest: None

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Background: Diabetes mellitus is a metabolic disease and its complications are interlinked and usually have a common soil. The clinical effect of diabetes on erythropoiesis is always interesting as the production of red cells is always at high rate and continuous, yet the red cell mean life span of 120 days is of an appropriate length, making it an excellent candidate for tests to detect the effect of diabetes and its complications and monitor for the response to treatment. Aim of the study: To determine the level of reticulocyte percent in patients with uncomplicated type 2 Diabetes Mellitus and to evaluate the effect of folic acid treatment on this percent. Patients, controls and methods: 140 patients with type 2 Diabetes Mellitus were included in this study. The exclusion criteria from this study were anemia, pregnancy, personal and family history of hemolytic anemia, overt microvascular complications of DM (retinopathy, neuropathy and nephropathy), acute infection and/or inflammation and history of chronic disease other than diabetes. The patient medical record was reviewed and peripheral blood specimen withdrawn for determination of hemoglobin concentration, PCV %, reticulocyte % and HbA1c. A subgroup of (82) patients (45 males and 37 females) were chosen who consented on not to change their treatment for the next coming one month except for the addition of daily one 5mg tablet of folic acid. PCV %, hemoglobin concentration, reticulocytes % were tested for using manual techniques. HbA1c % was measured using automated HPLC machine. Results: This study revealed increased red cell destruction in type 2 diabetics in comparison to healthy control subjects of the same sex and age. Also the reticulocyte increment was more in those with higher HbA1c %, although it was not in linear relationship with it. These findings are suggesting that the initiating event for red cell hemolysis is the increased blood glucose level. Conclusion: Type 2 diabetes patients are subject to oxidative stress as a result of hyperglycemia. This study suggests that the addition of folic acid treatment to the regime of type 2 diabetic patients can be useful.

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