Prevalence and factors associated with anemia among patients with type 2 diabetes mellitus in northeastern Thailand: A cross-sectional study

Abstract

Introduction Anemia is a common complication in individuals with type 2 diabetes mellitus (T2DM), particularly in regions where thalassemia and iron deficiency are prevalent. However, the relative contribution of genetic hemoglobin disorders in this context has not been well characterized. This study aimed to determine the prevalence of anemia and to identify factors associated with its occurrence among patients with T2DM in northeastern Thailand. Methods A cross-sectional study was conducted among 210 patients with T2DM attending two community health-promoting hospitals in northeastern Thailand. Data on sociodemographic characteristics, hematologic indices, renal function, iron status, and thalassemia genotypes were collected. Anemia was defined according to World Health Organization criteria. Factors associated with anemia were evaluated using multivariable logistic regression analysis, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Results The prevalence of anemia was 54.3%. Thalassemia and related hemoglobinopathies were present in 60.5% of participants, and iron deficiency in 39.5%. Independent predictors of anemia included two or more α-globin gene defects or Hb E co-inherited with α-thalassemia (adjusted OR: 37.8; p = 0.002), Hb E trait (OR: 3.6; p = 0.006), iron deficiency (OR: 3.7; p < 0.001), and chronic kidney disease stages 2 (OR: 3.5; p = 0.002) and 3–4 (OR: 15.7; p < 0.001). Conclusion Anemia was highly prevalent among patients with T2DM in this community-based cohort from northeastern Thailand. Thalassemia-related genotypes, iron deficiency, and chronic kidney disease were significantly associated with anemia. These findings highlight the importance of considering inherited hemoglobin disorders when evaluating anemia in T2DM patients in hemoglobinopathy-endemic regions.