DIABETES AND ANEMIA: A SCOPING REVIEW

Abstract

Background: Diabetes mellitus is a chronic metabolic disorder associated with several hematological abnormalities, among which anemia is increasingly recognized as an important comorbidity. Although anemia is frequently attributed to diabetic kidney disease, its etiology is multifactorial and includes iron deficiency, inflammation, nutritional deficiencies, medication-associated abnormalities, and impaired erythropoietin production. Objective: This review aims to map the available evidence concerning the prevalence, mechanisms, clinical consequences, diagnosis, and management of anemia among individuals with diabetes mellitus. Methods: A scoping review framework was adopted to organize the literature on diabetes-associated anemia. Relevant evidence includes observational studies, clinical reviews, systematic reviews, meta-analyses, and clinical trials addressing the epidemiology, pathophysiology, evaluation, and management of anemia in people with diabetes. A reproducible database search and formal study-selection process should be completed before this draft is submitted as a finalized scoping review. Results: Published evidence indicates that anemia is common among people with diabetes, with prevalence varying according to population characteristics, renal function, diagnostic criteria, and comorbid conditions. A systematic review and meta-analysis published in 2024 reported a pooled prevalence of 35.45%. Diabetic kidney disease, relative erythropoietin deficiency, iron deficiency, chronic inflammation, and medication-associated vitamin B12 deficiency are important contributors. Anemia may coexist with diabetic retinopathy, nephropathy, neuropathy, and cardiovascular disease, although the strength and direction of these associations vary across studies. Conclusion: Anemia represents a clinically relevant but potentially underrecognized complication in people with diabetes. Its early identification requires a systematic assessment of hemoglobin, renal function, iron status, and other hematological parameters when indicated. Further research is needed to establish standardized screening strategies and determine whether targeted correction of anemia improves long-term outcomes in this population.