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Mean normal hematocrit values are 36 to 46 for menstruating women and 41 to 53 for men and postmenopausal women. The anemia associated with diabetes is due to a reduction in erythropoietin production thought to be secondary to (a) renal denervation from diabetic neuropathy, (b) alterations in the structures within the renal cortex resulting in a reduced erythropoietin response to the hypoxic stimulus of anemia, and (c) a reduction in levels of androgen hormones that stimulate erythropoiesis. 190 Prior to the availability of recombinant human erythropoietin (rHuEPO, epoetin alfa), anemia was treated with iron supplements or blood transfusions.

Adequate BP control across the drug-dosing interval during awake hours can be determined. If the BP tends to rise above the designated treatment target after supper, alterations in the drug dose or interval should be considered. Perhaps addition of another therapeutic agent may be necessary to allow targeted BP control throughout the day. HBPM can evaluate the effectiveness of increasing or decreasing doses of antihypertensive drugs during titration.

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