Alteraciones eritrocitarias en pacientes con diabetes mellitus: revisión sistemática

Abstract

Diabetes Mellitus (DM) presents a hyperglycemia that causes hematological disorders, consequently, changes in erythrocytes at structural, functional and rheological level are presented, one of the alterations is the decrease of erythrocytes, increase in aggregation and erythrocyte sedimentation rate among others. These multiple changes in erythrocytes can generate greater viscosity and produce a disturbed microcirculation. One of the difficulties in patients with DM who present erythrocyte alterations is anemia due to the decrease of erythrocytes, anemia is 2 to 3 times more frequent in patients who present the pathology than in those who do not suffer from Diabetes Mellitus, in addition patients with DM can present anemia with absence or presence of nephropathies. There are two types of anemia, among them we have anemia due to chronic diseases and iron deficiency. It is necessary to perform tests of glycosylated hemoglobin, fasting glucose test, to prevent possible pathologies associated with DM, once diagnosed DM can be observed the different alterations of erythrocytes in patients with diabetes mellitus type 2 (DM2) by scanning electron microscopy and anatomical force microscopy, complete blood counts and complementary tests are also performed to identify erythrocyte alterations, anemia and the types of anemia presented by the pathology, this is essential to minimize the high mortality rate. The objective of this review is to carry out a bibliographic review of erythrocyte alterations in patients with Diabetes Mellitus. A systematic review was carried out using different search engines, one of them being Pub Med of the last 15 years using the PRISMA method. The results of erythrocyte alterations show changes in the morphology of erythrocytes presenting spherocytes in patients with type 1 diabetes mellitus and in patients with type 2 diabetes mellitus presenting spherocytes and echinocytes, decreased deformability and increased aggregation. In addition, patients with DM without nephropathy present iron deficiency anemia. In conclusion, patients with hyperglycemia present alterations in erythrocytes, morphology, function and rheology, to observe the changes in patients with DM2 the anatomical force microscope and scanning electron microscope were implemented. It should be noted that one of the most frequent complications in patients with DM is anemia. To identify erythrocyte changes and anemia it is necessary to perform laboratory tests to avoid complications