Diabetes mellitus - Bone marrow and peripheral blood stem cell

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

Essential information

Obligatory

Must not donate if:

  1. Requires treatment with insulin.
  2. Has had a transplant of pancreatic tissue.
  3. Has significant end-organ complication. See Discretionary below.
  4. Suffers from hypoglycaemic attacks.
  5. Diabetes is poorly controlled. See Additional information below.
Discretionary

The donor needs to be reviewed by the Designated Clinical Support Officer if they suffer from complications of diabetes mellitus which may cause a health risk to the donor or recipient. Complications include peripheral vascular disease, renal impairment, autonomic neuropathy and cardiovascular disease.

Hypoglycaemic attacks are less common in type 1 diabetes but can still be a complication of some medications.

Supporting information

Additional information

Diabetes mellitus can result in acute illness, chronic morbidities and death, and hence national guidelines recommend maintaining good glycaemic control to prevent or minimise macrovascular and microvascular complications.

It is estimated that 3.8 million of the UK population have diabetes (8.6%) [The state of the nation 2019: A review of diabetes services in Wales].

Type 1 diabetes (T1DM) comprises the minority (<10%) and the patients are insulin dependent, more prone to have hypoglycaemic events. It is, at least in part, considered to be genetically inherited. A review of the medical literature suggests that T1DM may be transmitted to the recipient after a successful transplant.

Type 2 diabetes (T2DM) is more common and many people with this type are in good health and do not require insulin treatment.

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).

Diabetic patients are advised to maintain good glycaemic control (HbA1c 7–8%, 52–64 mmol/mol) to prevent macrovascular and microvascular complications.

UK Blood and Tissue Services accept donors who are on oral medications for diabetes following 2008 review and recommendation by the Standing Advisory Committee on Care and Selection of Donors (SACCSD), and later this recommendation was reviewed to accept donors using some non-insulin derived injectable drugs. Serious Hazards of Transfusion (SHOT) donor haemovigilance has not reported any donor adverse events related to diabetes. (SHOT 2009–2021).

The Blood Safety and Quality Regulations 2005 require UK Blood and Tissue Services not to accept donors who are being treated with insulin, or who have received a transplant of human tissue.

Reason for change:
Updating the guideline.
Version details:

BM-DSG Edition 203 Release 47 (31 May 2022)