A 58-year-old woman with Type 2 diabetes presents with fatigue, pallor, and dizziness. Lab tests show a hemoglobin level of 10.5 g/dL. What could be causing these symptoms and what should be the management plan?
This patient's symptoms and laboratory results suggest anemia. One potential cause in a patient with diabetes could be chronic kidney disease (CKD), which can lead to decreased erythropoietin production, causing anemia. Further investigations should be done including serum creatinine, eGFR, and urinalysis to check for kidney disease. Other causes of anemia should also be considered, and further workup including iron studies, B12, folate, and a peripheral blood smear should be undertaken. Management will depend on the underlying cause.