The occurrence of iron-deficiency anemia in children with type 1 diabetes

J Investig Med. 2014 Aug;62(6):865-7. doi: 10.1097/JIM.0000000000000098.

Abstract

Objective: A higher risk for iron deficiency, which can lead to anemia, has been noticed in children with early stages of type 1 diabetes. Anemia in diabetes is not uncommon and thus may contribute to disease complications. The aim of the study was to determine the influence of type 1 diabetes incidence on the manifestation of iron-deficiency anemia.

Materials and methods: The study included 100 children with type 1 diabetes, aged 6 to 17 years. The diagnosis of type 1 diabetes in all patients was made on the basis of clinical symptoms and, at a later stage, on the basis of the occurrence of islet cell autoantibodies. The patients were divided into groups according to the duration of the disease: those with newly diagnosed type 1 diabetes (ND), those who have the disease for 1 to 3 years (FMD), those who have it for 4 to 6 years (SMD), and those who have it for more than 6 years (LD). Morphological parameters of blood have been measured by means of the flame atomic absorption spectrometry method: red blood cells (RBC), hemoglobin (HGB), acetylated HGB, hematocrit (HCT), RBC volume (mean corpuscular volume [MCV]), HGB mass in RBC (mean corpuscular HGB [MCH]), mean HGB content in RBC (MCH concentration), and serum iron concentration.

Results: In the ND children, significantly lower concentrations of HCT and HGB as well as the amount of RBC and MCV have been shown, in comparison with the children who have type 1 diabetes longer: for HGB, compared with the FMD children; for HCT, compared with the SMD and LD children; for RBC, compared with the LD children; and for MCV, compared with the SMD children. Some significant inverse correlation has been observed in the MCH concentration in comparison with the children who have type 1 diabetes for more than 1 year. It has been shown that, when compared with the FMD, SMD, and LD children, more ND children are characterized by the coexistence of at least 3 reduced values of the morphological blood parameters associated with iron-deficiency anemia (26%, 17%, 7%, and 3%, respectively). At the same time, it has been found that the mean iron concentration in the blood serum of the ND group is significantly lower than that of the SMD and LD groups.

Conclusions: The incidence of anemia in the early stages of the disease justifies conducting the screening in all children with type 1 diabetes and taking appropriate preventive measures toward the patients at risk for iron-deficiency anemia.

MeSH terms

  • Adolescent
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / diagnosis*
  • Anemia, Iron-Deficiency / epidemiology*
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Erythrocyte Count / methods
  • Female
  • Humans
  • Male