Iron Depletion Improves Glycemic Control in Poorly Controlled Type 2 Diabetic Patients with Iron Overload and Negative Main HFE-Gene Mutations ()
ABSTRACT
Iron overload increases the risk of diabetes via mechanisms of
abnormal glucose metabolism: insulin deficiency, insulin resistance, and/or
hepatic dysfunction. Iron reduction upregulates glucose uptake and improves
hepatocytes insulin receptor activity. This study was conducted to examine the
effects of iron depletion—via controlled
phlebotomy—on the hypoglycemic treatment in poorly controlled type 2 diabetes
mellitus (T2DM) patients with non-genetic iron overload. Forty three patients
with poorly controlled T2DM and iron overload were divided into 2 groups: iron
depletion group and control group. Regular phlebotomy was performed for iron
depletion group on monthly basis until serum ferritin reached 20 μg/L
or less. Both groups were examined and compared for blood pressure, serum
ferritin, lipid profile, HFE-gene, HbA1c, HOMA-IR and number of medicines used
for diabetic control. The results had revealed that group differences of HbA1c (-2.64, 95% CI -3.23 to 2.04, p <
0.001) and HOMA-IR (-0.68, 95% CI -0.98 to -0.37, p < 0.001) showed significant
decreases in iron depletion group at end of study. Significant decrease in the
numbers of hypoglycemic medicines in iron depletion group was shown at end of
study (p < 0.001); 66.7% of iron depletion group patients were receiving 1
or 2 medicines at end of studyversus none of the control group. Diastolic blood
pressure (DBP), triglycerides and LDL-C decreased significantly while HDL-C
levels showed significant rise after iron depletion. It can be concluded from
the present study that iron depletion therapy is beneficial for improving the
efficiency of glycemic control, DBP, and dyslipidemia in poorly controlled type
2 diabetics with iron over load.
Share and Cite:
Mahmoud, A. , Elged, A. , Elgamal, R. and Hamada, A. (2015) Iron Depletion Improves Glycemic Control in Poorly Controlled Type 2 Diabetic Patients with Iron Overload and Negative Main HFE-Gene Mutations.
Journal of Diabetes Mellitus,
5, 164-172. doi:
10.4236/jdm.2015.53020.