Diabetes and Anemia

How Anemia and diabetes are related

If you count yourself among the more than 30 million individuals in the United State living with diabetes, you’re probably aware of some of the added risk you have for experiencing certain health complications. Diabetes increases the risk of cardiovascular disease, nerve damage, stroke, chronic kidney disease (nephropathy) and other disorders.

But did you know that diabetes has also been linked to anemia with up to 25% of all individuals living with Type 2 diabetes also living with anemia. Before we dig deeper, it’s important to note that diabetes itself does not cause anemia, nor does anemia lead to the development of diabetes. So having one does not automatically mean you’ll get the other. Nevertheless, there is an important link between the two that those living with diabetes should be aware of, and in this post, we’ll examine the connection and what you can do to avoid developing anemia.

What is Anemia?

Anemia, as described by the National Heart, Lung, and Blood Institute, is a medical condition in which the blood does not have enough healthy red blood cells (those that carry oxygen) for the body to function properly. Each year, over 3 million cases of anemia are diagnosed in the United States making it a relatively common disorder.

The link between Anemia and diabetes

Why do so many people with diabetes also experience anemia? As we detailed earlier, it’s not the diabetes itself that causes anemia. However, two common complications of diabetes – kidney damage and damage to the body’s blood vessels – are often the roots of an anemia diagnosis.

Kidney Disease and Anemia

As we know, one of the more common complications related to diabetes is kidney disease. It also happens to be a common cause of anemia. When the kidneys are functioning properly, they are responsible for releasing a hormone called erythropoietin (EPO). Healthy kidneys know when the body needs new red blood cells and will release EPO, which then signals the marrow in the bones to produce more red blood cells. When the kidneys are damaged, however, they are often unable to send out enough EPO to meet the body’s need for red blood cells. Eventually, this diminishes the number of functioning red blood cells to the point that an anemia diagnosis is made.

It’s also important to note that anemia could be an early warning sign. Kidney disease rarely presents any symptoms in the early stages. Most people don’t know they have it until it’s relatively far along and damage to the kidneys is severe. But, if you’ve been diagnosed with diabetes and get diagnosed with anemia, it might be the body telling you that there’s a problem with your kidneys.

Inflamed Blood Vessels and Anemia

Another link between diabetes and anemia concerns the body’s blood vessels. People with diabetes, particularly those who have difficulty managing blood sugar and experience frequent or prolonged blood glucose highs, can experience damage to the blood vessels. Most notably, vessels can become inflamed, preventing the bone marrow from receiving the EPO signal to produce more red blood cells. Without proper signaling, new red blood cells the body needs are never created, which leads to a deficiency and, eventually, an anemia diagnosis.

Diabetes Medications and Anemia

There’s also evidence that diabetes medications can increase the likelihood of anemia. Some medications, such as ACE inhibitors, fibrates, metformin, and thiazolidinediones can drop the levels of the protein hemoglobin, which is necessary for the blood to carry oxygen to the body. If you take one of these medications, it’s a good idea to speak with your diabetes physician about the risk of anemia.


Symptoms of Anemia

The symptoms of anemia include many of the same symptoms one might experience when having an episode of hyperglycemia or high blood sugar. They include:

– Extreme fatigue

– Dizziness/lightheadedness

– Headache

– Rapid heart rate

– Shortness of breath

– Pale skin

– Low body temperature

– Cold hands and feet

Because some of these symptoms overlap with the symptoms of hyperglycemia, if you experience them, don’t jump to the conclusion you have anemia. Test your blood sugar to see if you’re experiencing a high. If not and the symptoms persist, ask your doctor about getting tested for anemia.


How is Anemia diagnosed?

Your doctor will give you a blood test that counts your red and white blood cells, platelets, and checks whether your blood cells are of normal size. If you have a deficiency in red blood cells, it may indicate anemia. The test also checks the level of hemoglobin in your blood. Low hemoglobin may also be a sign you’re anemic.

If you are, other tests will follow to determine the cause. Iron deficiency, kidney damage, bone marrow health, and vitamin deficiencies can all be at the root of anemia.


Treating Anemia

There are many ways to treat anemia. If an iron deficiency is the cause, it might be as easy as changing your diet or adding supplements. If it is kidney related and EPO production is the problem, there are synthetic versions of the hormone that might be able to help. Once your doctor determines the cause, the best course of action can then be determined.

What can you do?

For starters, make sure your diet has enough iron. Most adult women need about 18 milligrams per day, while men only need about 8 milligrams. Foods rich in iron include beans, lentils, green leafy veggies, fish, tofu, dried fruits, and iron-fortified breads and cereals.

Another thing you can do is keep your blood sugar under control. The diabetes-related complications that can lead to anemia, kidney disease and damaged blood vessels, result from uncontrolled blood sugar. But, when your diabetes is properly managed, your risk of anemia is reduced.

– Test your blood sugar regularly using a glucose meter and test strips or a CGM device.

­– Eat right and get a proper amount of physical activity each week (150 minutes as recommended by the American Diabetes Association).

– Follow your doctor-prescribed diabetes medication and treatment program.

– See your doctor right away if you experience undo difficulty maintaining target blood sugar levels. Remedying the problem might be a simple fix – a dietary or medication adjustment – but ignoring the problem will certainly not make it go away.


We hope you found this post informative and insightful. At Diabetic Warehouse, we’re committed to helping those with diabetes manage blood sugar with a complete selection of testing and treatment supplies at prices up to 65% less than those found at most pharmacies and suppliers.

Diabetic Warehouse is a trusted supplier of diabetes care products and accessories. For more information and to explore a complete range of products, including glucose meters and test strips, insulin syringes, pen needles, continuous glucose monitoring systems, and more, visit