Background: Older age has a significant association with anaemia. However, this has
not been adequately investigated in the context of specific comorbidities such as Type 2 Diabetes
Objectives: To investigate the role of age in Normocytic Anaemia (NCA) and the adverse outcomes
of NCA in T2DM.
Methods: Patients with NCA, either unexplained or related to Chronic Kidney Disease (CKD),
were recruited from a diabetic clinic over six months. Anaemia was defined as a haemoglobin(Hb)
< 130g/l for men and <120g/l for women. The relevant data were obtained by interviewing patients
and review of medical records. Patients were followed for 12 months for pre-defined adverse outcomes.
Results: Of the 354 patients assessed, 203 were included (mean age 63.12 ± 13.62 years, males
49.8%). The prevalence of NCA was 24% (49). Older age had a significant univariate association
with NCA (p < 0.001) and this remained significant (adjusted Odds Ratio (OR) 1.24, 95% CI 1.16-
5.29) after adjusting for estimated Glomerular Filtration Rate (eGFR) < 60ml/min/1.73m2, albuminuria
and other potential confounders. Adjusting for eGFR as a continuous variable also confirmed
this significant association (OR1.15, 95% CI 1.10-7.01). In the subgroup of patients aged ≥
75 years, only older age was significantly associated with NCA. The incidence of all-cause mortality
and composite cardiovascular/cerebrovascular events was similar in the anaemic and nonanaemic
Conclusion: NCA is common in T2DM and has a significant association with older age independent
of CKD. The anaemia is mild in most patients and appears to have a benign course.