Diabetes mellitus progression in β-thalassaemia major patients: The impact of iron overload

Abstract

ABSTRACT Regular blood transfusion therapy and enhanced iron absorption in patients with β-thalassemia major lead to progressive accumulation of iron in the patient’s tissues. Iron overload disrupts the function of pancreatic β-cell, deteriorates insulin resistance, increases blood glucose levels, and precipitates diabetes mellitus (DM). A family history of DM, obesity, sedentary lifestyle, and age increase the risk of DM in β-thalassemia patients. The prevalence of DM among individuals with β-thalassemia major is on the rise despite considerable screening and management efforts. Therefore, more research is still warranted to fully understand the molecular underpinnings linking β-thalassemia major and the onset and progression of DM to develop more robust screening and management approaches. In this context, no reliable biomarkers are currently available to predict or detect DM in such patients. In this review, we elaborate on key tentative links between thalassemia and DM and expand on established metabolic alterations that associate with DM in patients with β-thalassemia major. The review also addresses the prevalence rates and patient management strategies and underscores the need for identifying DM-related predictive and diagnostic biomarkers in β-thalassemia major patients.