Volume 1 number 1 Summer 2003
Special issue for the abstracts of the 7th Pan Arab Conference on Diabetes
PACD7 , 25 – 28 March 2003 Cairo

Abstract Number : 42
Prevalence of Some Causes of Anemia in 
Type 1 Diabetic Children. A Pilot Study

Nermine Salah (MD); Fayza Abdel Hamid (MD)*
Shereen Abdel Ghaffar(MD); Mohammed El Sayem 
Pediatric and Clinical Pathology Departments* Cairo University

Anemia in type 1 diabetes is common and has diverse aetiologies. Two hundred patients were screened for anemia. Anemic patients were subjected to full history revising the nutritional intake, signs and symptoms of hypothyroidism, celiac disease or of chronic hemolytic anemia. Laboratory workup included complete blood count, serum iron and total iron binding capacity, serum folate, and serum B12 as well as hemoglobin electrophoresis. Thyroid profile and renal functions were also tested. Screening for celiac disease was done using antigliadin, antireticulin and antiendomysial autoantibodies. Patients positive for antibodies underwent intestinal biopsy to document the diagnosis.

Mean age of anemic patients was 11.15 + 5.1 yr. (range: 1.58-26). Mean duration of diabetes was 4.02 + 3.33 yr. (range: 0.1-15.3). Prevalence of anemia among the screened patients was 37.5%. Forty-five patients (60%) had microcytic hypochromic anemia, 18 patients (24 %) had normocytic normochromic anemia, while 12 patients (16 %) had macrocytic hyperchromic anemia. Iron deficiency anemia was detected in 41 patients (54.7%), folate deficiency anemia in 14 patients (18.7%) and thalassemia intermedia in 14 patients (18.7%) [with overlap between thalassemia intermedia and iron deficiency in eight patients}. Three patients (4%) proved to have celiac disease. In addition, eighteen patients (24%) had evidence of parasitic infestation in the form of Entamoeba histolytic, Oxyuris or giardia infection. 

By comparison of HbA1 in iron versus non-iron deficient patients, it was detected that HbA1 was statistically significantly higher in iron deficient than in non-iron deficient patients [10.13 + 0.69 vs. 8.62 + 0.71, p < 0.01]. HbA1 significantly decreased statistically after iron supplementation [8.36 + 0.66 vs. 9.45 + 1.02 % respectively, p < 0.01]. Proper and early diagnosis of anemia in diabetic patients can permit its adequate treatment aiming at better health and well being. 

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