Association of diabetes mellitus with thalassaemia and sickle cell disease
Katerina Thisiadou, Ioannis Karamouzis, Stella Arampatzi, Kostantinos Tomos & Despoina Michailidou
Background: The majority of complications in transfusion dependent thallasemic and with sickle cell anemia patients are due to iron overload. This is responsible for the beginning of haemosiderosis, clinical symptoms and dysfunction of important systems, specially after the 2nd decade of life. The increase of the iron accumulation is caused by hemolysis, high iron absorbance and mainly by transfusion treatment. The appearance of diabetes mellitus depends on the significance and duration of hemosiderosis, that has direct concequences to the secretive function of pancreatic β-cells.
Aim: The purpose of this study was to investigate glucose and ferritin levels and determine whether hyperglycemia is associated with iron overload in patients with thalassaemia and sickle cell anemia.
Patients and methods: Our groups consisted of 31 patients with β-thalassaemia (β-thal), intermedia thalassaemia (int.thal) and sickle cell anemia (s.c-an). We also used a control group of 26 healthy subjects. (h.s). The serum glucose levels (Glu)) were determined using photometric method while ferritin levels (Fer) were measured by electrochemiluminescence immunoassay.
Results: The mean value of the Glu and Fer in patients with omozygous β-thalassaemia gave a statistically significant difference (P<0.05) compared to the average value of the Glu and Fer in normal subjects. Glu was significantly and positively correlated with Fer (r=0.882, P<0.01) in patients with β-thalassaemia. The same conclusion goes for the patients with sickle cell anemia where the concentration of Glu was positively correlated with Fer (r=0.709, P<0.05).
Conclusions: Despite the systematic chelation therapy for the treatment of haemosiderosis, which is caused from the regular blood transfusions, there is a risk of iron overload which leads to endocrine complications such as diabetes mellitus as it is confirmed from our study.