Pancreatic beta-Cell Function Before and After Bone Marrow Transplantation for Thalassemia

Diabetes mellitus and impaired glucose tolerance are complications of thalassemic major patients treated by hypertransfusion schemes and chelation therapy. Diabetes in thalassemic patients seems to be the consequence of several factors. The iron overload damages the islet cells and also seems to decrease the sensitivity to insulin, which is compensated by increased secretion of insulin. So the diabetes may be due to a combination of insulin deficiency and insulin resistance. The insulin deficiency may be caused by either exhaustion of beta cells or beta-cell damage due to iron deposition, or a combination of these factors. Another important factor is liver damage due to iron overload and viral infections [1–3]; the combination of these factors could explain the development of impaired glucose tolerance and, in time, insulin-dependent diabetes in thalassemia patients. This study was undertaken to evaluate the impact of bone marrow transplation on beta-pancreas function in thalassemic patients.