INCREASED RISK OF DIABETES-MELLITUS IN BETA-THALASSEMIA MAJOR DUE TO IRON OVERLOAD

  • 1 January 1979
    • journal article
    • research article
    • Vol. 34  (3) , 197-207
Abstract
Frequent transfusions improve the general well being in patients with .beta.-thalassemia major, but carry the risk of Fe intoxication, including the development of diabetes mellitus. Of 22 patients with .beta.-thalassemia major (age 3-17 yr), only 3 had a normal oral glucose tolerance. The remainder had either borderline or moderately pathological glucose curves. The mean glucose concentration was increased and the mean insulin concentration and insulin: glucose ratio were diminished. In contrast to the oral test, the i.v. glucose tolerance test gave pathological results in only 2 of 16 patients tested. The i.v. glucose test may be less selective than the oral test. The mean insulin concentration was lower also after i.v. glucose, but the early insulin peak was preserved. Arginine infusion led to a normal insulin and growth hormone release. This moderate impairment of insulin release found in most of the patients leaves the hope that an efficient chelating therapy scheme might reverse .beta.-cell dysfunction.