Hemochromatosis or "Bronze Diabetes"

Continuing the discussion from Cats and diabetes:

I found it really interesting that @Vancouversailor mentions this. Hereditary Hemochromatosis is autosomal dominant, which means that if both parents have the mutation you have a one in four chance of inheriting both mutated genes and having hereditary hemochromatosis. Hemochromatosis causes abnormal control of the amount of iron your body absorbs from food and if you end up with too much iron it is toxic. Hereditary hemochromatosis is sometimes called “Bronze Diabetes.” Hemochromatosis can cause insulin resistance, hyperinsulinemia and impaired insulin secretion. There is some belief that many cases of hemochromatosis go undiagnosed and are misdiagnosed as Type 2 diabetes. The insulin resistance and hyperinsulinemia seen in bronze diabetes can cause the same sort of weight gain seen in Type 2 diabetes.

Some people with hemochromatosis never have symptoms. Unfortunately over time the damage from the excess iron can damage your pancreas, liver and other organs. You may only find out about hemochromatosis after the damage is done. Even if you normalize iron levels, apparently you cannot undo the damage. The tests for iron levels are serum transferrin saturation and serum ferritin.

The reason I know this is that I have a condition called polycythemia vera and I had both of these tests to rule out whether I had hemochromatosis (I do not). Despite that I have to do the same treatment that someone with hemochromatosis has to undergo, I have give blood on a regular basis.

I wonder, @Vancouversailor, have you been tested for hemochromatosis? Do you have abnormal iron levels? Have you been tested to see if you inherited two copies of the mutated gene. Being tested for this could be critically important Hemochromatosis (bronze diabetes) is not Type 2 diabetes . Being misdiagnosed as Type 2 could be dangerous as very bad things could happen over time if the hemochromatosis is not treated.

ps. We don’t really have a category to talk about types of diabetes other than Type 1 and Type 2, so I thought I would put it in “Treatment”

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Brian,
Thanks for your interest in this topic.
I was first diagnosed with diabetes type 2 at age 47. At the time neither my doctor or I knew about or had heard of hereditary hemochromatosis. Five years later I had a phone call from my older sister who lives in Norway. She told me that she had been diagnosed with hereditary hemochromatosis and that it was highly probable that her siblings had it as well. So my doctor referred me to a specialist who did a test that determined that I en fact did have the disorder. He also had my iron levels checked and found they were moderately elevated (500, while the norm is to be below 100). Often with a late diagnosis like mine iron levels are in the thousands not hundreds. The fact that mine were moderate were attributed to the fact that I had been a blood donor since my late teens, and that neither red meat (beef) or spinach, both of which are big sources of iron, had never been a part of my diet. At this point my endo confirmed that I do in fact have two separate diagnosis, hemochromatosis and diabetes type 2, the latter most likely caused by iron overload on my pancreas due to the former. He also explained that my type 2 differs somewhat from the more common ones in that the damaged pancreas still secrets sufficient insulin but that the reaction can be significantly delayed. That explained why I for 16 years was able to manage my blood sugars by eating only low GI carbs like beans, squash and rye bread and going for a 40 minute walk after each meal.

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I have to say, while I wouldn’t wish diabetes on anyone you are actually “triple lucky.”

First, you got diagnosed with bronze diabetes. Most people with Type 2 never get a diagnosis that identifies a cause of their diabetes. While we mostly understand that genetics has a big role and the development of insulin resistance and other defects play a role, most Type 2 diabetes is just totally “diabetes of unknown cause.” At least you know the cause your diabetes.

Second, given that you know the cause of your diabetes (your hemochromatosis) you can take action to minimize the progression of your diabetes. Most people with Type 2 have no control over the progression of their condition. In the Diabetes Prevention Program (DPP) only one in fourteen people using a lifestyle intervention were able to slow the progression of diabetes over 15 years enough to avoid full blown diabetes.

Third, you are blessed with a diabetes which has not required aggressive intervention and that has enabled you to manage your diabetes with pretty simple changes.

In the scope of things you are a pretty lucky guy.

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