Understanding the link between haemochromatosis and diabetes 

If you or a loved one are experiencing symptoms or have a family history of either condition, we encourage you to speak to your health professional for screening and diagnosis.  

What is haemochromatosis?  

Hereditary haemochromatosis is a genetic disorder that causes the body to absorb and store too much iron. Over time, iron builds up, increasing the risk of health issues, including diabetes. Organs commonly affected include the liver, heart, and pancreas.  

What is diabetes?  

The term ‘diabetes’ covers a range of conditions where the glucose (sugar) in the blood becomes higher than normal. This leads to raised blood glucose levels. There are many types of diabetes including type 1, type 2, LADA and MODY. When we look at the connection between diabetes and haemochromatosis, the term ‘secondary diabetes’ is most often used. This is when diabetes is caused by another medical condition such as haemochromatosis, damaging the pancreas.  

How are the conditions related?  

The pancreas, which produces insulin, is particularly vulnerable to iron overload. In haemochromatosis, iron stores can damage pancreatic cells, worsening insulin production. This can lead to secondary diabetes.  

Condition related symptoms  

Haemochromatosis symptoms  

It is important to note that most patients with haemochromatosis do not have symptoms until the condition is more advanced. More advanced symptoms of the condition include:  

•         Chronic fatigue 
•         Joint pain 
•         Abdominal pain 
•         Unexplained weight loss 
•         Skin darkening (bronze or grey tone) 
•         Liver dysfunction 
•         Loss of libido or erectile dysfunction 

Diabetes symptoms  

•         Frequent urination 
•         Excessive thirst 
•         Unexplained weight loss 
•         Fatigue 
•         Blurred vision 
•         Slow-healing wounds 
•         Recurrent infections (for example, thrush) 

If you experience symptoms like fatigue or weight loss, it’s important to talk with your health care provider and ensure you are investigating your symptoms early.  

Diagnosis and treatment  

Diagnosis  

Haemochromatosis is diagnosed by simple blood tests. If you are found to have elevated iron levels, your health practitioner can arrange for a simple genetic test (blood test) to check for haemochromotosis.  

Diabetes can be diagnosed with a fasting blood sugar level or HbA1c which estimates your average blood sugar level. 

Managing haemochromatosis  

Haemachromatosis is easily managed, and the core treatment is periodic venesections (blood removal) to reduce iron levels. 

Occasionally, medications are used to remove excess iron (chelation therapy). 

Managing diabetes  

•         Maintaining a healthy diet, incorporating regular exercise to your daily routine and ensuring to maintain a healthy weight 
•         In some cases, insulin may be required to manage blood glucose levels. 
•         Monitoring blood glucose with regular checks and maintaining time in range. 

Managing iron levels effectively can delay or prevent the onset of diabetes in people with haemochromatosis. It’s important to understand your risk early and seek advice.    

Support and resources  

Medical support  

Your GP is the first point of contact for diagnosis and treatment advice.   

Your GP may refer you to see a gastroenterologist or haematologist (specialists in haemochromatosis) for further investigation and management.  

Your GP is also the best point of contact for diabetes testing and management.  

Other specialists may also be required, particularly (but not exclusively) in cases of type 1 diabetes. These specialists include:  

• Diabetes nurse educator 
• Dietitian 
• Endocrinologist   

Support organisations  

There are many organisations available for people living with haemochromatosis and diabetes, including:  

 Thank you to the health experts at Haemochromatosis Australia for contributing to this article.