In the United States, the Food and Drug Administration does not have any regulatory restrictions against diabetics donating blood other than if the individual has received bovine source insulin since 1980. The concern here is not the diabetes but rather the bovine spongiform encephalopathy. As bovine source insulins were not widely available in the US, the diabetic would have had to specifically import it from Europe. (Of note, the FDA regulations require that is the donor answers that they are not certain whether they received bovine source insulin, they are deferred. Many donors answer "I do not know" and are therefore deferred when in reality they have not been exposed as it was not available in the US.) Donors may mistake this deferral as being due to their having diabetes. Here is the FDA guidance (http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/ucm074089.htm#RECOMMENDATIONSFORDONORDEFERRAL)

The AABB (formerly American Association of Blood Banks) does not prohibit diabetics from donating blood in their standards.

Each blood collection center in the US can have criteria more stringent that either the FDA and AABB so there is some variability among blood centers. At the collection center where I work, we allow donors with diabetes, whether controlled with diet, oral hypoglycemics, or insulin, to donate. The only instance where I can think where diabetes would have a negative affect on blood product and therefore an adverse effect on the patient would be in the rare instances where we collect granulocytes. If the donor had poor glucose control, this could impair neutrophil function. Since granulocyte donors are usually stimulated with corticosteroids, which would worsen glucose control, diabetics are deferred from granulocyte donation at my institution so this is not an issue.

The Canadian Diabetes Association states:

If you take insulin, you are not eligible to donate. The rationale is that donating blood could interrupt your blood glucose control, and potentially lead to a hypoglycemic reaction in the clinic or on the way home.

If you manage your diabetes with lifestyle or diabetes pills, you may be eligible, depending on your overall health and if you meet the eligibility criteria listed below. Many people who have type 2 diabetes have blood pressure and heart problems, which would prevent them from donating.

So, if you are on OHAs and on good control, you should be able to donate blood.

You can check table 1 on page 3 of this document as well: http://www.savingliveswithhelpfulguys.com/downloads_/Advocacy_Studies_and_Policy_Papers/j.1537-2995.2007.01252.x.pdf

I have type 2 diabetes, use insulin, live in the U.S., and donate blood regularly.

In our country the diabetic is not eligible because it is healthy and it is facing many problems such as hypertension, kidney disease ....

Diabetes is part of the final against indications for blood donation

Ann have they eer asked you to defer on a donation?

Czech Republic:

insulin treatment = permanent deferral

diet and/or peroral antidiabetic pills = donation is possible.

See: Guide to the Preparationm Use and Quality Assurance of Blood Components. Recommendation No. R(95)15, 16th ed., Council of Europe 2011.

In the UK, the UK Blood Services Standing Advisory Committee concluded that blood donation is safe for those who manage their diabetes with oral therapy and have no complications or other underlying medical conditions.

I can't find a specific exclusion for insulin-dependent diabetics, although all UK blood donors have to undertake a health screening questionnaire and be counselled before donating.

This is an interesting question. Two points to highlight: safety to donor and safety to recipient. As far as the donor concerned I am not aware of contraindications for blood donation just because the donor has diabetes (given other health checks are satisfactory). However diabetes is generally associated with complications and people with diabetes usually take different medications and may already have anaemia secondary to renal impairment, B12 deficiency....etc . Taking medications makes donation more restricted and you have to refer to you local guidelines on this. As for the recipient safety, a blood from a person with hyperglycaemia but otherwise healthy i.e. satisfy blood donation safety standards (does not have HIV, Hep B or C,......) would be quite safe to receive as the extra glucose would simply be regulated and utilised by the recipient's body. Here is a useful link to UK regulations for more useful information:

http://www.blood.co.uk/can-i-give-blood/

Hope this helps.

In the United States, the Food and Drug Administration does not have any regulatory restrictions against diabetics donating blood other than if the individual has received bovine source insulin since 1980. The concern here is not the diabetes but rather the bovine spongiform encephalopathy. As bovine source insulins were not widely available in the US, the diabetic would have had to specifically import it from Europe. (Of note, the FDA regulations require that is the donor answers that they are not certain whether they received bovine source insulin, they are deferred. Many donors answer "I do not know" and are therefore deferred when in reality they have not been exposed as it was not available in the US.) Donors may mistake this deferral as being due to their having diabetes. Here is the FDA guidance (http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/ucm074089.htm#RECOMMENDATIONSFORDONORDEFERRAL)

The AABB (formerly American Association of Blood Banks) does not prohibit diabetics from donating blood in their standards.

Each blood collection center in the US can have criteria more stringent that either the FDA and AABB so there is some variability among blood centers. At the collection center where I work, we allow donors with diabetes, whether controlled with diet, oral hypoglycemics, or insulin, to donate. The only instance where I can think where diabetes would have a negative affect on blood product and therefore an adverse effect on the patient would be in the rare instances where we collect granulocytes. If the donor had poor glucose control, this could impair neutrophil function. Since granulocyte donors are usually stimulated with corticosteroids, which would worsen glucose control, diabetics are deferred from granulocyte donation at my institution so this is not an issue.

Hi my friends

For the diabetic people ,i prefer the blood sausage(pudding) than the donating blood !

I remember being deferred for donation a few decades ago, but have donated regularly for the last 15 years or so. I have never had any problems myself after donating, and I have had diabetes more than 20 years. I have no major complications, just a little bit of neuropathy in my lower limbs (but I still have protective sensation).

i have A negative blood, which is unusual enough to always be in demand. My sister's life was saved by a blood donor about 15 years ago, and I have donated regularly ever since. I am glad to be able to do this in gratitude for my sister's life.

AFAIK, in India, blood banks and hospitals outrightly deny receipt of blood from any diabetic person even if he is otherwise hale and healthy! This query was flagged mainly to collate opinions and regulations related to diabetic blood donation worldwide so that a uniform policy may be developed. However, looking at the wide varied regulations, methinks a uniform international policy needs to be generated!

Secondly, what about platelet donations as they are extracted from blood and used and this does not involve much of problems associated with whole blood donation?

In Europe, insulin-dependent diabetic can not donate.

It is a clear double safety questions: first, for the donor, to avoid hypotension, hypoglucemia or any cardiovascular side effects; but, second, for the receptor, to avoid hypoglucemia (by theorical insulin amount present in plasma) or hyperglycemia.

In my country diabetic patients under pharmacological treatment cannot become blood donors especially for the safety of the recipient

We follow the same policy as outlined by Jeff Winters; persons with diabetes are allowed to donate even if taking medication and assuming they are not ineligible because of use of bovine insulin.

We know that about 1/2 to 1/3 of people with diabetes are not diagnosed. I am sure blood donations are accepted from many I diagnosed people with diabetes, apparently without major harm. Given this fact, I wonder what the logic is of denying blood from people with diagnosed diabetes?

I meant to say that donations are accepted from many UNdiagnosed people with diabetes.... (Sorry about the typo)

You are aware of this recent research (and yes, I am aware that this does not address recipient safety)? http://www.sciencedaily.com/releases/2012/05/120529211645.htm, there are a number of related articles now, and a connection with hemochromatosis alleles. My interpretation is that excess iron is a factor in the development of insulin resistance/metabolic syndrome in many people, probably more so in heterozygotes for hemochromatosis, which may be more common in countries where a lot of meat is eaten.

In Austria we accept type 2 diabetics, if their blood sugar is controlled by diet only. Diabetics with medication will be deferred. It's for the safety of the donor and the recipient.

Ours is a tertiary care teaching hospital and collect around 35000 units of blood per year. We accept diabetic donors who are not on insulin and otherwise healthy. Some institutions may adopt their own policy but most of the placed accept diabetic donors on medicines only.

Why did diabetics must donate?

First of all. Actually we only need around 5% donation rate. Also, it is safer if these were regular donors (at least twice a year, till four or five per year). So, we really need 2,5% of our population could be donors. If we allow that veteran donors (over 65 y) ang oldest adolescent (older 16 y) could donate probably we only need 5% population be regular donors.

Second. If we apply recent AABB y Cochrane recomendations about restrictive transfusion criteria we could avoid about 40% of all transfusions.

Third, if we also apply NATA recommendations and the update of Spanish consensus document of transfusion alternatives, so we treat actively all preoperative anemias, we will save another 40-50% of all transfusions.

Four, if we also apply British and French Guidelines about anticoagulant manage and plasma transfusion, we could avoid more than 2/3 of all plasma use.

After this reflexion. Must we increase the number of donors or use the blood properly and nicely, with criteria and evidence based?

Thanks

Dear Vageeshbabu,

Normally the blood donors are normal, healthy people who do not harbor any disease, any bacterial, viral and fungal infections, any parasitic infestations. Blood is not drawn from diabetic people because of the safety for the donor and recipient. Diabetic people when they donate blood may become, hypotensive or hypoglycemic. Hypoglycemia is as bad as hyperglycemia and could be fatal and hence, generally it is not desired that diabetics give blood donations. Diabetic patients taking bovine or porcine insulins may develop antibodies and it is not recommended that the antibody contaminated blood be given to any other person. Each country and each hospital may have its own rules and regulations which are quite strict. There is indeed no necessity to have a uniform policy for a generally objectionable practice. I understand that some hospitals at times may have scarcity of blood. In those urgent life-saving circumstances, if the blood from normal healthy volunteers is absolutely not available, then perhaps blood from carefully drawn from diabetics may be transfused under supervision of hospital authorities.

Diabetic patients are actually apparently likely to benefit from donating blood/blood letting, see http://www.biomedcentral.com/1741-7015/10/54, in view of the fact that about 10% of Americans and 25% of the Irish, are carriers fro hemochromatosis, a hereditary iron overload disease and excess iron appears to induce insulin resistance, and many people in the Western world particularly, eat lots of red meat, this is a very interesting finding

Dear Sigrid,

Diabetic patients who are carriers of Hemochromatosisor who have hemochromatosis, may benefit from blood letting but the blood which they let may not be used for transfusion. Obviously one would not want to transfuse blood from a diabetic patient who is a carrier or has hemochromatosis to any other patient or recipient.

how would having hemochromatosis negatively affect the blood, there would be a little more iron in it, but nothing infectious. The same question for diabetes.

J Hepatol. 2012 Nov;57(5):1126-34. doi: 10.1016/j.jhep.2012.04.040. Epub 2012 May 30.

Patients with hemochromatosis are vulnerable to bacterial infections due to iron overload. Besides, these patients may have other complications like organ damage due to hemochromatosis. Although, your arguments are quite reasonable and well-taken, please refer to the above paper published recently and the author suggests that blood from patients with hemochromatosis may be safe for transfusion only after the iron levels have been normalised. I would add to it that patients obviously should not have infections and also not have any other organ damage. Although, one can still argue saying that what has organ damage to do with the quality of blood. However, clinical trials have to be conducted where blood from patients with hemochromatosis who have iron overload and have organ damage was proved to be safe for transfusion. Similarly, patients with diabetes may have subclinical inflammation and their blood may contain various inflammatory markers and other biomarkers of atherosclerosis. My humble suggestion is that if one can get blood from a normal healthy donor for blood transfusion, why would any one risk the health of the recipient. Moreover, the hospitals generally follow the guidelines and you can sway the opinion of the health authorities by providing them with valid data drawn from large clinical trials.

I do not understand and recognize fundamental of denying that. But, at Vadodara, India - people deny it. standard format of checklist excludes almost all NCDs for the same.

Diabetics who are on oral hypoglycemic agents and not on insulin may be accepted as blood donors if otherwise healthy and have blood sugar levels maintained within the acceptable range. However, the decision to accept or defer a blood donor with diabetes must be evaluated individually.

Type 2 DM can donate safely for Type 1 it is clinically unsafe and if should be done for any reason you need to do that after being sure that the patient is at optimal conditions for donating blood + a blood glucose and clinical follow up for at least 8-12 hours after donation ( speaking about Type 1 DM)

Yes. But it depend of blood type

Please!

First, The blood donor must be altruistic, voluntary and sane. And donor must not be in risk during donation.

But, second, receptor must be receive the best product possible with the lowest risk as possible. With the transfusion, our patient will receive, not only allogeneic cells, also sugar and different drugs, like insulin, from the "diabetic" donor. Theorically, the amount of those drugs in plasma transfusion could be dangerous.

Fist, do not "sweetly" harm!!!

The criteria for being eligible to donate whole blood (or platelets or plasma by apheresis) are strictly controlled at national level in most countries, when they have well structured blood collection organization and national regulatory authorities. There are also international guidelines defining exclusion/deferral criteria for donating blood. Diabetes which is medically well controlled by diet or oral medication (even in some countries, but not all, insulin, depending upon its production method) is not, in principle, an exclusion criteria for donating blood. However, each donor, in well regulated and organized systems, should go through a medical interview which ultimately will lead to a medical-based decision whether the donor is eligible or not to donate whole blood or blood components by apheresis. Well structured blood collection organizations publish informations to potential blood donors, which indicate the risk factors and exclusion criteria for blood donation. This may be readiliy available from their respective website. .

Dear all,

I fully agree with Thierry.

In Germany, we allow diabetes type II patients to donate blood as long as they do not use Insulin. The rationale for this beeing the "more severe" forms of DM type II. Diabetes type I patients are not allowed to donate blood since most of them aquire the disease in early childhood.

All donors are seen by a medical doctor before each donation. Diabetes medication is evaluated and the decision to only allow red blood cell donation (RBC) without platelets or therapeutic Plasma can be taken according to the risk Level of the drugs ingested.

At Spain, like most of European coustries, since 2004, it is a definitive exclusion criteria: "diabetes, that precises treatment wiht insulin" (1.6).

Another definitive exclusion criteria are: severe arterial hypertension (1.7); severe cardiovascular disease (1.1); severe central nervous system disease (1.2); bleeding history (1.3); epilepsy or sincope (1.4); and cronic active severe respiratory, renl, metabolic, inmunological, genitourinary or hematologic disease (1.5)!

RD 1088/2005

1. Criterios de exclusión permanente para donantes homólogos. Se excluirá de forma definitiva a los candidatos a donantes con:

1.1 Enfermedad cardiovascular: padecer o haber padecido enfermedad cardiovascular grave, excepto anomalías congénitas curadas.

1.2 Enfermedad del sistema nervioso central (SNC): historia de enfermedad del SNC grave.

1.3 Diátesis hemorrágica: historia de coagulopatía hemorrágica.

1.4 Episodios repetidos de síncope, o antecedentes de convulsiones: a) Exclusión definitiva si existe historia de epilepsia bajo tratamiento continuado. Se aceptarán los que en los últimos tres años no presentaron crisis ni requirieron tratamiento anticonvulsivante; b) Se descartarán las personas con episodios convulsivos no etiquetados, estén o no sometidas a tratamiento.

Los antecedentes de síncopes o convulsiones en la infancia o adolescencia no son motivo de exclusión.

1.5 Enfermedad gastrointestinal, genitourinaria, hematológica, inmunológica, metabólica, renal o respiratoria grave, activa, crónica o recidivante.

1.6 Diabetes que precisa tratamiento con insulina.

1.7 Hipertensión arterial grave.

Insulin dependent diabetics are deferred. However diabetics who are well controlled on oral hypoglycaemic so without cardiovascular disease risk can donate blood.

Dear Mohammad,

the recipients of blood components are not the ones to worry about re. blood donor on insulin since insulin is not a harmful drug, but a hormone. The person we worry about is the diabetic donor on insulin, since this is a first sign in a type 2 diabetic, that the disease reached a higher disease level, therefore, there is a relative risk of late diabetic complications like micro-/macroangiopathy, renal disease, etc. This si the reason for us to exclude such donors.

Best,

Markus

There is a certainty that the Type 1 DM patients are excluded from donating blood even though they are keen to donate, as regards to the type 2 DM they can donate subject to they full fill the criteria (for instance additional co-morbidities like CV diseases,high blood pressure,metabolic syndrome etc.,)   set forth by the respective health authorities of the countries, nowadays there is stringent guidelines in place for most of the countries and is readily available for the donors in the official web site of the federal health authorities.

I suppose that i have added a point to the discussion.

Dear colleague,

Varied and paraphernalia of responses only indicate that globally, still, there is a requirement of parameters for safe blood donation by diabetics. This question was raised to evaluate the feasibility of acceptance of blood from even diabetic donors in case of emergencies when healthy donors are not available. Secondly, many donors may not declare that they are diabetic, during blood donation camps, leading to receipt of their blood also. Problems and technical difficulties exist in involving diabetic blood donors. However, it should not limit a philanthropic diabetic donor from contributing his/her blood. Appropriate science-based solutions should exist to accept all types of donors, as far as possible. Medical science has progressed tremendously. Surprisingly, the preparedness is weak, hazy and mired in unclear responses! This is unacceptable in present day!

Kindly preferably provide responses that include how to empower diabetic blood donation, irrespective of extant national/international regulations. Please discuss techniques, methods and contingency measures too!

Interesting chain of thoughtful deliberations; please continue; useful ideas can emerge!

From knowledge acquired, Type 1 DM patients cannot donate, to avoid hypotension. Type 2 DM patients without any complications can donate.

Type 2 DM can donate blood safely when their diabetes is under control and fulfilling the donation criteria's . Type 1 DM patient can not donate the blood