Effect of erythropoietin treatment on hemoglobin A1c levels in diabetic patients with chronic kidney disease

Okel, Ahmed Z El; El-Arbagy, Ahmed R; Yassein, Yassein S; Khodir, Seham Z; Kasem, Heba E.

doi:10.4103/jesnt.jesnt_2_19

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Anaemia, which is common in the early post-transplant period, may lead to false low HbA1c levels [9]. Moreover, erythropoietin treatment or blood cell transfusions can change HbA1c levels independently of glycaemic changes [10,11]. Therefore, HbA1c should be used with caution and in combination with other criteria like fasting plasma glucose [12].…”

Section: Limitations Of Hba1c In the Diagnosis Of Ptdmmentioning

confidence: 99%

Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Rodríguez-Rodríguez

Hornum

Donate‐Correa

et al. 2021

Nephron

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Post-transplant diabetes mellitus (PTDM) is a frequent and relevant complication after renal transplantation: it affects 20–30% of renal transplant recipients and increases the risk for cardiovascular and infectious events. Thus, understanding pathogenesis of PTDM would help limiting its consequences. In this review, we analyse novel aspects of PTDM, based on studies of the last decade, such as the clinical evolution of PTDM, early and late, the reversibility rate, diagnostic criteria, risk factors, including pre-transplant metabolic syndrome and insulin resistance (IR) and the interaction between these factors and immunosuppressive medications. Also, we discuss novel pathogenic factors, in particular the role of β-cell function in an environment of IR and common pathways between pre-existing cell damage and tacrolimus-induced toxicity. The relevant role of prediabetes in the pathogenesis of PTDM and cardiovascular disease is also addressed. Finally, current evidence on PTDM treatment is discussed.

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Section: Limitations Of Hba1c In the Diagnosis Of Ptdmmentioning

confidence: 99%

Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Rodríguez-Rodríguez

Hornum

Donate‐Correa

et al. 2021

Nephron

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“…Also, Sultan et al [24] who reported that there was a significant difference between the studied groups regarding EPO. In addition, EL Okel et al [25] reported that GFR levels showed no significant difference between the studied diabetic and non-diabetic CKD patients.…”

Section: Discussionmentioning

confidence: 81%

Serum Erythropoietin Hormone Measurement for Evaluation of Anemia and Red Cell Parameters in Diabetes Mellitus and Diabetic Kidney Disease Patients

Alaidy,

Hasan,

Ibrahim

et al. 2024

International Journal of Medical Arts

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Article informationBackground: Anemia is a common complication of diabetes mellitus and diabetic kidney disease [DKD], leading to significant morbidity and decreased quality of life. Serum erythropoietin [EPO] levels play a crucial role in the regulation of erythropoiesis, and alterations in EPO levels may contribute to the development of anemia in these patients. Aim of the work:This study aimed to investigate the utility of serum EPO hormone measurement in evaluating anemia and red cell parameters in patients with diabetes mellitus and DKD. The study sought to assess the correlation between serum EPO levels, hemoglobin concentration, hematocrit, and other red cell indices in these populations.Patients and Methods: A total of 120 patients grouped into 3 groups; 40 patients with diabetes mellitus and no renal abnormality [eGFR>90 ml/min/1.73 m2], 40 patients with DKD [eGFR 15-90 ml/min/1.73 m2], and 40 healthy control. Serum EPO levels were measured and correlated with hemoglobin levels, hematocrit and various red cell parameters. Renal function, HbA1c and iron profile were also collected and analyzed. Results:The results indicated a significant association between serum EPO levels and anemia severity in patients with diabetes mellitus and DKD.In diabetic patients without renal issues, EPO correlated positively with Hb and ESR but inversely with RBCs, CRP, and serum ferritin. In diabetic patients with CKD, EPO linked positively with Hb and eGFR but negatively with UACR, WBCs, RBCs, and serum ferritin. EPO was a significant predictor of anemia in both groups. Conclusion:Serum EPO measurement provides valuable insights into the pathogenesis of anemia in diabetes mellitus and DKD patients.Monitoring serum EPO levels may aid in the assessment of anemia severity, guide appropriate treatment strategies, and offer prognostic information regarding kidney function in diabetic individuals.

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“…Furthermore, HbA1c levels may be misleadingly high due to the combination of anaemia and use of erythropoietin [ 35 ]. It is known that the use of erythropoietin may result in falsely elevated HbA1c [ 36 ]. One of the participants with eGFR of 9 mL/min/1.73 m2 was using erythropoietin substitution but did not have a hypoglycaemic episode during the five-day period.…”

Section: Discussionmentioning

confidence: 99%

High number of hypoglycaemic episodes identified by CGM among home-dwelling older people with diabetes: an observational study in Norway

Fløde,

Hermann,

Haugstvedt

et al. 2023

BMC Endocr Disord

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Background A scoping review from 2021 identified a lack of studies on the incidence, prevention and management of hypoglycaemia in home-dwelling older people with diabetes. The aim of this study was to investigate the frequency and duration of hypoglycaemic episodes measured by continuous glucose monitoring (CGM) in older people with diabetes who received home care and who were treated with glucose-lowering medications, and to compare the frequency and duration of hypoglycaemic episodes between subgroups of the study population according to demographic and clinical variables. Methods This was an observational study investigating the occurrence of hypoglycaemia in people with diabetes aged ≥ 65 years. Data were collected using blinded continuous glucose monitoring (CGM, iPro2) for 5 consecutive days. Frequency and duration of hypoglycaemic episodes were assessed using a sensor glucose cut-off value of 3.9 mmol/L. A blood sample for measurement of HbA1c and creatinine-based eGFR (CKD-EPI) was obtained during the monitoring period. Demographic and clinical data were collected from electronic patient records. Results Fifty-six individuals were enrolled (median age 82 years and 52% were men). Of the 36 participants who were treated with insulin, 33% had at least one hypoglycaemic episode during the five-day period. Among 18 participants who neither used insulin nor sulfonylurea, but other glucose-lowering medications, 44% had at least one hypoglycaemicepisode. Of those with hypoglycaemic episodes, 86% lived alone. The median duration of the hypoglycaemia was 1 h and 25 min, ranging from 15 min to 8 h and 50 min. Conclusion This study identified an unacceptably high number of unknown hypoglycaemic episodes among older home-dwelling people with diabetes receiving home care, even among those not using insulin or sulfonylurea. The study provides essential knowledge that can serve as a foundation to improve the treatment and care for this vulnerable patient group. The routines for glucose monitoring and other prevention tasks need to be considered more comprehensively, also, among those treated with glucose-lowering medications other than insulin.

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Effect of erythropoietin treatment on hemoglobin A1c levels in diabetic patients with chronic kidney disease

Cited by 5 publications

References 4 publications

Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Post-Transplant Diabetes Mellitus and Prediabetes in Renal Transplant Recipients: An Update

Serum Erythropoietin Hormone Measurement for Evaluation of Anemia and Red Cell Parameters in Diabetes Mellitus and Diabetic Kidney Disease Patients

High number of hypoglycaemic episodes identified by CGM among home-dwelling older people with diabetes: an observational study in Norway

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