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# Diabetes mellitus - Whole blood and components

Also known as: type 1 and type 2 diabetes, sugar diabetes

## Essential information

Obligatory

  Must not donate if:

  1. Requires treatment with insulin.
  2. Diabetes medication has been altered in the last 4 weeks.
  3. Is having problems with feeling faint, fainting or giddiness.
  4. Has suffered from heart failure.
  5. Has renal impairment requiring dialysis, the use of erythropoietin or similar drugs, or is either under active investigation or continued follow-up for renal impairment.
  6. Has required surgery for a blocked or narrowed artery including any type of amputation.
  7. Has or has had gangrene.
  8. Has or has had ulcers or wounds related to a loss of sensation.
  9. Has had a transplant of pancreatic tissue.
Discretionary
  1. If diagnosed with pre-diabetes or gestational diabetes but not requiring treatment, accept.
  2. If controlled by diet or oral medication or injectable medication other than insulin, e.g. exenatide (Byetta??) or liraglutide (Victoza??), that has not been changed in type or dose in the last 4 weeks, accept.
  3. If previous treatment with insulin (including bovine insulin) was stopped more than 4 weeks ago, accept.
  4. If gangrene was not related to diabetes or peripheral vascular disease (e.g. it was due to hypothermia or meningococcal meningitis) and all wounds are fully healed, even if amputation was required, accept.
  5. If a donor has a glucose monitoring device to manage their diabetes and is otherwise eligible according to the above criteria, then as long as there is no inflammation or infection at or around the site of the skin sensor, accept.

## Supporting information

See if relevant
  - Cardiovascular disease
  - Cerebrovascular disease and intracranial haemorrhage
  - Chiropody
  - Infection, general
  - Pregnancy
  - Shunts, stents and devices
  - Tissue and organ recipients
  - Wounds, mouth and skin ulcers
Additional information

  In the UK, about 1 in 20 individuals has diabetes. The majority of cases do not require treatment with insulin. Many people with this type of diabetes, often called type II (2), are in good health and are fit to donate blood.

  It is, however, important that complications due to diabetes are carefully assessed and, where necessary, donors are excluded from donating (e.g. those at risk of postural hypotension due to autonomic neuropathy, or those at risk of bacteraemia due to unhealed ulcers).

  The rationale for not accepting donors on oral medication for diabetes mellitus was reviewed by the Standing Advisory Committee on the Care and Selection of Donors (SACCSD) in 2008. It was decided that available data did not support the deferral of all individuals with diabetes that required treatment.

  It is a requirement of the Blood Safety and Quality Regulations 2005 not to accept donors who are being treated with insulin, or who have received a transplant of human tissue.

  Diabetic donors should be informed that blood donation will lower their HbA1c (glycated haemoglobin) levels. This blood test is used to monitor their diabetic control. Donors should inform their diabetic team that they are blood donors so this can be taken into account when reviewing HbA1c levels. Blood donation should preferably be performed after HbA1c testing.

  HbA1c decreases under conditions which shorten the life-span of red blood cells (RBC). HbA1c is made when the glucose (sugar) in the body sticks to the RBC. As the body cannot use the sugar properly more of it sticks to the RBC and builds up in the blood. RBC are active for around 3 months. By measuring HbA1c, clinicians are able to get an overall picture of what a patient's average blood sugar levels have been over a period of weeks/months. For people with diabetes, this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications.

  According to national guidelines people with type 1 diabetes should be offered a continuous glucose monitor (CGM) or flash glucose monitor (e.g. FreeStyle Libre??). Some people with type 2 diabetes may also be offered a CGM or flash glucose monitor. Care should be taken to ensure donors are eligible in regard to their diabetes as most will be using insulin, often via a pump, which would preclude them from donation, and/or will be having difficulties monitoring or controlling their blood glucose levels and donation at that time would not be advisable.

  Glucose monitoring devices are available to buy and donors with stable diabetes not treated with insulin may have chosen to buy a device to use.

Regulatory information

  Part of this entry is a requirement of the Blood Safety and Quality Regulations 2005.

Reason for change:
  Link updated from 'Central Nervous System Disease' to 'Cerebrovascular Disease and Intracranial Haemorrhage' in the 'See if Relevant' section.
Version details:

  WB-DSG Edition 203 Release 73 (07 October 2024)

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