Diabetes Mellitus and Pernicious Anemia

Abstract

From 1959 to 1968, thirty-six cases of pernicious anemia (PA) were noted in 11,144 patients with diabetes mellitus (DM) at the Joslin Clinic (incidence 3.2/1,000). Of the thirty-six, only one was not insulin dependent. The female to male ratio was 7:5. Age ranged from thirty-four to eighty-one years. In twenty-eight patients with DM, a mean period of 12.6 years elapsed from time of diagnosis of diabetes mellitus to development of PA. In eight, PA preceded DM by a mean period of 6.6 years. Vitamin B12 deficiency neuropathy was present in nine patients and in only six of these was there clinically recognizable anemia. Hypothyroidism was present in two patients. Histochemical and immune abnormalities common to both disorders are reviewed and possible causes for association are discussed.