Diabetes and Anemia

By Dr. Frank Varon, DDS

What is anemia?

Anemia is a medical condition in your blood when either your hemoglobin or hemocrit are below normal. Hemoglobin is a complex molecule in your red blood cells that carries the oxygen to the tissues in your body. The hemocrit is a percentage of red blood cells to the total volume of blood contained in a sample. This condition can be temporary (rapid blood loss) or a long-term illness depending on the cause. Mild anemia may have mild or no symptoms, while more severe anemia symptoms are more pronounced with tiredness. About one-fourth of all people with diabetes will have problems with anemia.


How serious is anemia?

For untreated diabetes patients, anemia increases your chances of developing diabetic eye diseases (retinopathy), heart disease, and having a stroke. Death rates for patients with anemia are much higher than those without it. Higher death rates are more common for anemic diabetes patients who also have heart failure and/or kidney disease. Treatment of the anemia does not guarantee a longer life. Problems are further complicated due to the frequency of kidney disease in diabetes. A damaged kidney does not produce adequate amounts of erythropoietin, which controls red blood cell production in your bone marrow.


What are the symptoms?

The majority of anemic symptoms are due to a sheer lack of oxygen to the tissues in your body. Some common problems are:

  • Tiredness
  • Weakness
  • Headaches
  • Peripheral neuropathy in fingers and toes
  • Difficulty in concentration
  • Pale skin color
  • Sore tongue
  • Poor sense of balance (severe)
  • Shortness of breath (severe)
  • Rapid heartbeat (severe)


What are some of the causes?

Chronic kidney disease/Kidney failure results in decreased production of erythropoietin, which controls red blood cell production.

Vitamin B12 deficiency develops when you cannot absorb this vitamin from food.

  • Pernicious anemia occurs when your body destroys cells responsible for absorption of vitamin B12.
  • Surgery that alters the surface area of your stomach or the last section of your intestine (ileum)
  • Digestive diseases such as Celiac disease and Crohn's disease
  • Treatment for acid reflux or stomach ulcers using Prilosec and Prevacid.
  • Diabetes drug therapy with metformin. Anemia occurs in nearly 30% of diabetes patients using metformin for at least three years.
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