Document Type : Original research articles
Authors
1
Clinical and Chemical Pathology Department, Faculty of Medicine, South Valley University, Qena, Egypt.
2
Internal Medicine Department, Faculty of Medicine, South Valley University, Qena, Egypt.
Abstract
Background: Diabetes mellitus (DM) is a growing public health issue in Egypt. Chronic hyperglycemia, impaired erythropoietin production, and increased RBC fragility, lead to increased destruction.
Objective: To assess the red cell osmotic fragility status and its determinants in type 2 DM (T2DM) patients.
Patients and methods: A cross-sectional study involving 200 participants, 100 with T2DM, and 100 controls, subjected to clinical, physical examination, and laboratory investigations, including an osmotic fragility test.
Results: Anemia was prevalent in 56% of T2DM; 93% had HbA1c > 7, a higher rate of infection, and the presence of complications and associated comorbidities. Anemic patients have higher WBC, platelets, reticulocyte counts, CRP, and ferritin; hemolysis starts at higher NaCl%, especially in females. Hemolysis is linked to various health indicators, including age, disease duration, blood pressure, red cell indices, inflammatory markers, kidney function, and lipid levels. The HbA1c positively correlated with disease duration (r=0.3321, p=0.001), systolic BP (r=0.3342, p=0.001), serum creatinine (r=0.456, p < 0.00001), cholesterol (r=0.5552, p < 0.00001), and VLDL (r=0.3342, p=0.001), and negatively correlation with diastolic BP (r=-0.3318, p=0.001), MCV (r=-0.317, p=0.001), triglycerides (r=-0.3212, p=0.001), and eGFR (r=-0.2391, p=0.0166).
Conclusion: Anemia was prevalent in T2DM patients, accompanied by the presence of comorbidities and complications. Poor glycemic control leads to a decline in RBC count, indices, and increased fragility, which may exacerbate disease progression and worsen complications. Regular monitoring and strict glycemic control aid in complication prevention.
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