<<snip>>
Type 1 diabetes mellitus  is believed to be due to the damage inflicted by iron
overload of the pancreatic beta cells
<<snip>>

Pediatr Diabetes. 2004 Sep;5(3):126-32.  Related Articles, Links  

Abnormal glucose tolerance in Egyptian beta-thalassemic patients: possible
association with genotyping.

Khalifa AS, Salem M, Mounir E, El-Tawil MM, El-Sawy M, Abd Al-Aziz MM.

Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo,
Egypt.

Khalifa AS, Salem M, Mounir E, El-Tawil MM, El-Sawy M, Abd Al-Aziz MM. Abnormal
glucose tolerance in Egyptian beta-thalassemic patients: possible association
with genotyping.Abstract: Background: Type 1 diabetes mellitus (DM) is a
frequent complication in patients with beta-thalassemia. It is believed to be
due to the damage inflicted by iron overload of the pancreatic beta cells.
Liver disorders and genetic influences seem to be additional predisposing
factors. Objective: To study the prevalence of diabetes and impaired glucose
tolerance (IGT) in transfusion-dependent Egyptian beta-thalassemic patients and
to evaluate the possible role of genotyping in the pathogenesis of diabetes
associated with beta-thalassemia. Research design and methods: A total of 56
transfusion-dependent beta-thalassemic patients aged 10-31 (mean age = 15.9 +/-
5.7 yr), 32 males and 24 females, including 48 thalassemia major and eight
thalassemia intermedia; compared to 15 age- and sex-matched controls. All were
subjected to history and examination, laboratory investigations: complete blood
count (CBC), serum ferritin, liver function tests, hepatitis B and C markers,
fasting blood glucose, oral glucose tolerance test (OGTT) and fasting
C-peptide. Genotyping for 16 mutations was assessed in thalassemic patients
with abnormal glucose tolerance. Results: The prevalence of diabetes was 10.4%
(5 of 48) and IGT was 14.6% (7 of 48) among thalassemia major, whereas, none of
thalassemia intermedia had abnormal glucose tolerance. Fasting C-peptide was
lower in beta-thalassemic patients compared to controls (p < 0.001); the level
was significantly higher in patients complicated by diabetes or IGT compared
with other thalassemic patients (p < 0.001). Chronic hepatitis C was detected
in all patients (100%) with abnormal glucose tolerance. Genotyping showed that
IVS II nt 745 was detected in 77.7% of cases with abnormal glucose tolerance.
Conclusions: Abnormal glucose tolerance is common in multiply transfused
beta-thalassemia major patients, which could be attributed to progressive and
early loss of beta-cell mass, along with persistent insulin resistance. Chronic
hepatitis C may play a role in the development of abnormal glucose tolerance.
An association between diabetes and genotyping IVS II nt 745 was found.
Patients with this particular genotype are advised to check their blood glucose
every 6 months to detect early occurrence of diabetes.

PMID: 15450007 [PubMed - in process]

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