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  • Iron Depletion Improves Glycemic Control

    From ironjustice@21:1/5 to All on Wed May 6 05:44:26 2020
    Iron Depletion Improves Glycemic Control in Poorly Controlled Type 2 Diabetic Patients with Iron Overload and Negative Main HFE-Gene Mutations
    Vol.5 No.3, August 2015 PP. 164-172
    DOI: 10.4236/jdm.2015.53020
    A. Mahmoud1*, Adel A. Elazab Elged2, Rasha A. Elgamal2, Abdelhady M. Hamada2 1Internal Medicine Department, Ain-Shams University, Cairo, Egypt.
    2Clinical Pathology Department, Ain-Shams University, Cairo, Egypt.

    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.

    KEYWORDS

    Iron Overload, Poorly Controlled Diabetes, Phlebotomy, Hypertension, Dyslipidemia
    Cite this paper

    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.

    https://www.scirp.org/journal/paperinformation.aspx?paperid=58429

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