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Glucose intolerance / iron excess
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PostPosted: Thu Jul 13, 2006 2:46 pm    Post subject: Glucose intolerance / iron excess Reply with quote

Effect of enhanced iron chelation therapy on glucose metabolism in
patients with beta-thalassaemia major.
Farmaki K, Angelopoulos N, Anagnostopoulos G, Gotsis E, Rombopoulos G,
Tolis G
Br J Haematol. 2006 Jul 4;

Recently introduced chelation regimens that combine deferoxamine (DFO)
and deferiprone have been shown to have greater efficacy in promoting
iron excretion than either chelator alone and have been associated with
rapid reduction of the iron load in the heart and liver, and with
reversal of cardiac dysfunction. It is unclear whether this combined
therapy could be associated with a reduction in iron load or decline in
the severity of iron-induced endocrinopathies. Starting in January
2001, 42 patients with beta-thalassaemia major, previously maintained
on subcutaneous DFO only, were switched to combined treatment with DFO
and deferiprone. The primary endpoint was to investigate the effects of
this therapy on the glucose metabolism characteristics of this
population. Combination therapy markedly decreased ferritin levels (638
+/- 1345 vs. 2991 +/- 2093 mug/l, P < 0.001). Glucose responses were
improved at all times during an oral glucose tolerance test,
particularly in patients in early stages of glucose intolerance.
Glucose quantitative secretion also decreased significantly with
combined therapy, while no significant change occurred in insulin
levels in any group. Insulin secretion, according to the homeostasis
assessment model, markedly increased in all groups, while overall
reduction in insulin sensitivity did not reach statistical
significance. This study showed that the combination of DFO and
deferiprone was associated with an improvement in liver iron deposition
and glucose intolerance.

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