Individual at risk
Donor
Guidance at RECRUITMENT
UNACCEPTABLE
Guidance at CT/WORK-UP
ACCEPTABLE if type II diabetes controlled with diet or oral medication alone, and no other risk factors for cardiovascular disease are present.
DEFER if type I diabetes/MODY, or type II diabetes requiring insulin.
Justification for guidance
Diabetes confers an increased risk of occult cardiovascular or cerebrovascular disease, which may confer a greater risk of serious adverse events during donation (either bone marrow or PBSC). Diet-controlled diabetics are generally less likely to have prolonged, poorly controlled blood glucose levels, and thus have a lower incidence of microvascular and arterial damage.
However, it is recognised that very few people with type 2 diabetes are able to maintain glucose control to target levels using lifestyle measures alone. Considering the time between recruitment and donation in the majority of cases, it is advisable to defer all diabetics at recruitment, as these donor are more likely to be medically deferred if eventually called to donate several years later.
References
Morgan CL, Currie CJ, Peters JR. Relationship between diabetes and mortality: a population study using record linkage. Diabetes Care 2000; 23(8): 1103-7.