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How is anemia and diabetes detected ?

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General & Family Physician
Practicing since : 2010
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Resulting from query to doc (this doc new to me - he is not up to speed with my history), regarding numb, cold toes at night only (and some complaint about persistent overweight [see below]:
Have just received blood work from lab. (obtained via internet from lab)Can not see my doc right away, but I am curious to understand report :
Hemoglobin L 126, RBC L 4.16, Hematocrit L 0.39, Gamma GT H 171, Cholesterol H 7.5, LDL cholesterol H 4.7, Triglycerides H 2.6. No other flagged indicators.
Doc noted very fast pulse, but ECG not flagged: "ECG (12 lead) performed and sent out."
Doc surmised onset diabetes.
In interim have consulted with my psychiatrist - whom I trust utterly. Discussed above, he surmised "pernicious anemia" based on fast pulse, B12 deficiency, sedentary lifestyle. Advised exercise and diet. I follow his advice always, and feel anyway that I have been very vigilant of my diet for many years (no sweets, no fats, cholesterol). But is true, have not been getting exercise esp. in last 6 months during which time I have felt extraordinarily depressed, housebound, also during which time my prior weight loss of approx 15 lbs has all returned - to my gut! Am starting a walking regime for exercise (for the 1,000'st time! Always ends in severe back pain!).
Neither doc has raised issue of codeine abuse: new doc does not know about it; shrink was informed of it many years ago and has likely forgotten about it.
I learned of connexion to anemia via my own Internet research.
Posted Sat, 5 May 2012 in Diabetes
Answered by Dr. Sunil.N 8 hours later
Hi ,

Thanks for your query.

According to your Lab reports, Hb, RBC , Haematocrit - Anaemia is evident. To know the type of anaemia and correct treatment, Peripheral smear test and Anemia profile (understood at lab) is required. Only after doing this test we can ascertain the cause for Anaemia like B12 deficiency, Iron deficiency etc. Fast pulse can be a compensation for your anemia and the other medications that you take. Your psychiatrist is right in his advice. But there is still testing remained as above. I would like to get a Stool for occult blood at this age.

Gamma GT is at a higher level , its interpretation should be done with the other liver enzymes parameters.

Triglycerides , Total Cholesterol and LDL Cholesterol are at high level indicates the Hypercholestrolemia and Hypertriglyceridemia and requires the treatment to bring down the Increased cholesterol and triglycerides.

Co-relating the anaemic status and the symptoms , Vit B12 can be considered as the possible cause but only the lab test like Vit B12 assays can confirm it.

Good you stopped codeine medication but without any withdrawal symptoms is rather surprising.Yes few of the studies have shown that codeine can causes Anaemia.But the exact cause is not determined.

Continue with your walking and follow the strict diet.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: How is anemia and diabetes detected ? 11 hours later
Thank-you Dr. XXXXXXX

Do you see any indicator of onset diabetes, as my new doc had surmised? If so, what is the indicator for that?
Answered by Dr. Sunil.N 3 hours later
Hi Again ,

Thanks for the follow up query.

There were such kind of Indicators of onset Diabetes in the information provided by you.

Following test indicates the Diabetes :
1.RBS - Random Blood Sugar level ,if the value is >200mg/dl its sure case of diabetes.

2.FBS - Fasting Blood Sugar level and PPBS - Post Prandial Blood Sugar level of values >126 and >200 mg/dl respectively are confirmatory of the Diabetes mellitus.

Hope this helps you.

Wish you good health.
Above answer was peer-reviewed by
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