Interplay Between Oxidative Stress and Erythropoiesis in Diabetes: Emerging Roles of Neuromodulators and Natural Product Antioxidants in Anaemia Management

Fabiola Mwendwa G.

 

School of Applied Health Sciences Kampala International University Uganda

ABSTRACT

Anaemia is a common and underappreciated complication of diabetes that worsens quality of life, increases cardiovascular risk, and accelerates progression of diabetic complications. Multiple interacting mechanisms contribute to diabetes-associated anaemia, including reduced erythropoietin (EPO) production, iron dysregulation, shortened red blood cell (RBC) lifespan, bone marrow suppression, and chronic inflammation. Oxidative stress-driven by hyperglycaemia, dyslipidaemia, mitochondrial dysfunction, and advanced glycation end-products-is a central, unifying mediator that perturbs erythropoiesis at molecular and cellular levels. Beyond direct oxidative damage to erythroid precursors and mature RBCs, redox imbalance alters signaling pathways (HIF, JAK/STAT, NF-κB), disrupts iron handling (hepcidin–ferroportin axis), and modulates neuro-immune interactions that can influence hematopoiesis. Neuromodulators (endogenous and drug-like agents that alter neural input to hematopoietic and immune compartments) and natural product antioxidants (polyphenols, flavonoids, terpenoids, alkaloids, and omega-3 fatty acids) are emerging as promising adjuncts for correcting redox-driven defects in diabetic erythropoiesis. This review integrates mechanistic insights into oxidative stress–mediated suppression of erythropoiesis in diabetes, evaluates evidence that neuromodulatory pathways intersect with hematopoietic regulation, and examines preclinical and clinical data for natural antioxidants as supportive therapies in diabetic anaemia. We highlight therapeutic strategies, formulation and safety considerations, and research priorities needed to translate these biologically plausible interventions into clinical practice.

Keywords: Diabetic anaemia, oxidative stress, erythropoiesis, neuromodulation, natural antioxidants

 

CITE AS: Fabiola Mwendwa G. (2026). Interplay Between Oxidative Stress and Erythropoiesis in Diabetes: Emerging Roles of Neuromodulators and Natural Product Antioxidants in Anaemia Management. IDOSR JOURNAL OF BIOLOGY, CHEMISTRY AND PHARMACY 11(1):47-51. https://doi.org/10.59298/IDOSR/JBCP/26/102.4751