Risk Factors

What is bronze diabetes?

Sometimes a disease of the gene can cause iron accumulation in the tissues of the body. This results in hemochromatosis, also known as bronze diabetes, which if untreated can result in diabetes. It is prevalent in the population, almost on par with type 1 diabetes. However, most of the time it remains a less diagnosed disease. In fact, hemochromatosis is referred to as "bronze diabetes" because of the appearance of some patients when they are diagnosed.

Hereditary hemochromatosis is the most common single-gene disease in Western populations, affecting 1 out of every 200-300 people. Most of the public have not heard of it and many health professionals have little idea as to what it is.

The iron overload mechanism

This is one of the most common "iron overload" disease, which is characterized by an excess accumulation of iron in the body. What happens in hemochromatosis, is that a single gene mutation causes extra iron to be absorbed from food in the intestine, while the body lacks an efficient means of excreting the excess iron it takes in.

Over a period of time, this iron accumulates in the tissues of the body, particularly in the pancreas, the liver, and the heart and damages these organs.

When left untreated, the disease can cause these organs to fail, leading to diabetes, cirrhosis, and heart disease.

How to spot a bronze diabetic

The initial symptoms of hemochromatosis can be diverse and blurred which may appear like the symptoms of many other diseases. Also, doctors may focus on the conditions caused by hemochromatosis -- arthritis, liver disease, heart disease, or diabetes, rather than on the underlying iron overload.Joint pain is reported to be the most common complaint of people with hemochromatosis at the time of diagnosis. Some patients also report fatigue, lack of energy, abdominal pain, and loss of sex drive, as well as the symptoms typically seen with diabetes and heart disease. Symptoms tend to occur in men between the ages of 30 and 50 and in women over age 50. In many patients, the buildup of iron eventually becomes so excessive that it visibly shows up in the skin, turning it a dark gray or bronze color.

A ‘transferrin saturation test’ or a ‘serum ferritin test’ can determine whether the amount of iron stored in the body is too high. Despite its prevalence and the availability of simple tests for it, hemochromatosis is often undiagnosed and untreated.

The gene link

Hemochromatosis is caused by a defect in a gene, which helps regulate the amount of iron absorbed from food. A person who inherits the defective gene from both parents may develop hemochromatosis. It has been found that persons who inherit the defective gene from only one parent are carriers for the disease but usually do not develop it, although they may have slightly increased iron levels.

In the case of hemochromatosis, it is believed that a single individual in Europe, 60 to 70 generations ago, was the sole origin of most of the hemochromatosis seen in the world today. Because of its origin, hemochromatosis today most often affects Caucasians of Northern European descent, although other ethnic groups can be affected by other iron overload diseases.

Being a woman helps!

Although both men and women can inherit the hemochromatosis gene, men are much more likely to be diagnosed with the effects of hemochromatosis than women, and men also tend to develop problems from the excess iron at a younger age. This could be because women regularly lose a significant amount of blood every month until menopause, as well as during childbirth, resulting in loss of significant amount of iron associated with that blood.

Treatment

The most simple and straightforward treatment for hemochromatosis is phlebotomy, or blood-letting. When first diagnosed, people with hemochromatosis are put on an intensive schedule of phlebotomy to bring their iron levels down. They must give a pint of blood once or twice a week, often for many months. There is no risk of passing on a genetic disease through blood transfusions. Measures of blood iron levels are monitored, and when they are finally in the normal range, the patient is put on a maintenance schedule of giving a pint of blood at greater intervals, usually every 2 or 3 months. Unlike diabetes, hemochromatosis is virtually cured through its treatment, with patients remaining completely asymptomatic as long as iron levels are monitored and maintained in the normal range.

Associated conditions of hemochromatosis such as liver disease, heart disease, arthritis, and diabetes can be prevented, if treatment begins before any organs are damaged. The hope factor for people who already have these conditions at diagnosis depends on the degree of organ damage. For example, treating hemochromatosis can stop the progression of liver disease in its early stages, which means a normal life expectancy. However, if cirrhosis has developed, the person's risk of developing liver cancer increases, even if iron stores are reduced to normal levels.

The good news for people with diabetes as a result of pancreatic damage is that an improvement in their diabetic condition can be seen, if not a reversal, depending on how much damage has occurred.