Related Experiment Video
Updated: May 10, 2026
05:23
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Total mortality by elevated transferrin saturation in patients with diabetes
Christina Ellervik1, Henrik Ullits Andersen, Anne Tybjærg-Hansen
1Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark. christina@ellervik.dk
Diabetes Care
|June 27, 2013
Summary
Iron overload, indicated by high transferrin saturation, independently predicts mortality in patients with late-onset type 1 diabetes. Early monitoring and intervention for iron overload can improve life expectancy in this population.
Area of Science:
- Endocrinology
- Genetics
- Hematology
Background:
- Iron overload is a concern in diabetes, but its prognostic significance and independence from HFE genotype are unclear.
- Transferrin saturation is a key indicator of iron status.
Purpose of the Study:
- To determine if iron overload predicts prognosis in diabetes patients.
- To assess if iron overload is an independent risk factor for mortality, irrespective of HFE genotype.
- To evaluate the utility of early transferrin saturation measurement in predicting mortality outcomes.
Main Methods:
- Two cohorts were studied: Cohort 1 (716 patients with late-onset type 1 diabetes) and Cohort 2 (6,120 patients with any diabetes).
- Measurements included transferrin saturation and HFE genotype.
- Analysis focused on total and cause-specific mortality in relation to transferrin saturation levels and HFE genotypes.
Main Results:
- In Cohort 1, elevated transferrin saturation (≥50%) was associated with increased total mortality (HR 2.3) and cancer mortality (HR 5.8).
- The HFE genotype C282Y/C282Y significantly predicted mortality (total HR 4.0, cancer HR 13).
- In Cohort 2, no significant difference in total mortality was observed based on transferrin saturation levels, but a protective effect was noted in late-onset type 1 diabetes patients with elevated transferrin saturation (HR 0.4).
Conclusions:
- Increased transferrin saturation and the HFE C282Y/C282Y genotype are independent predictors of mortality in late-onset type 1 diabetes.
- Early measurement and intervention for iron overload in these patients can enhance life expectancy.
Related Concept Videos
01:15Diabetes: Symptoms, Diagnosis, and Complications
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:28Diabetic Nephropathy
Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
01:22Diabetes Mellitus: Type 2 and Gestational
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
01:36Carbohydrate Metabolism
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...