The full text of this 2007 article provides a good comprehensive review of the role of iron in diabetes. This 2007 full text comment on the above review adds important perspective to this discussion.
In this study reported from China in 2010 the researchers st out "to investigate the relationship of gamma-glutamyl transferase to ferritin, and their interaction on the risk of type 2 diabetes." "A total of 436 men and 588 women were recruited. In 2006, these researchers reported a study of 490 Greek individuals with metabolic syndrome.
In this 2007 study of a group of 944 individuals in France, and over a period of six years, both ferritin and transferrin levels were significantly associated to the development of metabolic syndrome. Figure 1—Age-adjusted ORs (95% CI) for the 6-year incidence of the IDF-defined metabolic syndrome according to high ferritin and transferrin levels (both above the upper tertiles) (A), lower ferritin and high transferrin levels (B), high ferritin and lower transferrin levels (C), and lower ferritin and lower transferrin levels (D).
In 2006, data from the above French study was analyzed to determine the association of ferritin and transferrin to glucose metabolism. Figure 1—Standardized ORs for the 3-year incidence of hyperglycemia (IFG or type 2 diabetes) according to baseline iron biomarkers and CRP (independent variables) after adjustment for baseline age, BMI, WHR, and glucose and insulin concentrations in the DESIR study.
In this 2005 Italian study of 269 metabolic syndrome and 210 control subjects, ferritin in metabolic syndrome subjects was significantly higher than in controls.
In this 2008 study of a population of 110 women with diabetes from Kuwait, researchers found an association of elevated ferritin with diabetes, but not with metabolic syndrome. Figure 1 Serum ferritin levels in male (white boxes) and female (grey boxes) individuals discriminated according to the presence or absence of defining criteria of the insulin resistance syndrome (A–F). As in the study described directly above, this was a 2012 reported study from the large EPIC epidemiologic survey undertaken in Europe.
This 2007 reported study of incident type 2 diabetes the researchers recruited participants from four clinical centers in the U.S. This 2009 study was based on "a longitudinal population-based study of approximately 6,600 Danes in a nested case-control design with the primary outcome of 5-year conversion to type 2 diabetes. In this 2010 study from Iran, serum ferritin was measured in 128 pregnant women (64 women with gestational diabetes and 64 age-matched controls). This 2011 study was reported by researchers from Division of Epidemiology, Statistics and Prevention at the National Institutes of Health. In another study from Iran in 2008, serum ferritin measurements in 25 obese menstruating women and 25 non-obese menstruating women matched for age were obtained.
In 2008 these researchers examined the expression of iron transport molecules in NAFLD patients with or without iron overload, in hemochromatosis patients and in controls.
This 2003 review further differentiates iron loading in NAFLD patients from that observed in hemochromatosis patients, and discusses findings that patients with chronic hepatitis and the C282Y hemochromatosis genotype "are more likely to suffer from advanced hepatic fibrosis or cirrhosis and to do so at younger ages." and, "A role for modest iron overload in increasing severity of alcohol-induced liver disease has been well established from results of experimental studies.
This is an early study (2000) that explores insulin resistance in NASH and the role of iron.
This 2009 research was reported in a study of 38 NASH patients, compared to 24 with simple steatosis (fatty liver) and 10 health subjects. In this 2009 study, the researchers measured and compared markers of hepatic oxidative stress in 38 patients with non-alcoholic steatohepatitis (NASH), 24 simple steatosis (NAFLD or fatty liver disease) and 10 healthy subjects.Oxidative stress was significantly higher in NASH patients than in those with NAFLD, and was related to iron overload, glucose-insulin metabolic abnormalities, and severity of disease.
This 1999 study done in France characterized insulin resistance associated with hepatic iron overload.
In this 2008-reported, large population based survey conducted in Beijing and Shanghai, 3,289 participants aged 50-70 years were examined for fasting plasma ferritin, glucose, insulin, lipid profile, glycohemoglobin, inflammatory markers, adipokines; and dietary profile were collected. This 1997 research was first to characterize this syndrome of unexplained hepatic iron overload and normal transferrin saturation.
In a 2011 study of 65 NASH patients in Turkey the investigators measured iron metabolism markets and inflammatory cytokines. In a paper published in 1999, this research team in France examined 161 non-C282Y homozygous patients (i.e. This 2010 paper presents a possible molecular explanation for the accumulation of iron in NASH patients. This 2005 review describes the interaction of alcohol with increased iron absorption in alcoholic liver disease patients. This review discusses several other factors that are likely contributors to the accumulation of iron in alcohol liver disease. This animal (rat) study provides more insight into alcoholic liver disease and the mechanism of iron accumulation in hepaocytes.
Complications of pregnancy are the symptoms and problems that are associated with pregnancy. Maternal Factors – these are congenital or acquired conditions of the mother and environmental factors that had adversely affected pregnancy outcome and led to abortion.
Complete or Total Placenta Previa – the placenta completely covers the internal os when the cervix is fully dilated. Marginal Placenta Previa – the edge of the placenta is lying at the margin of the internal os.
Low lying Placenta Previa – the placenta implants near the internal os, its edges can be felt by the examining finger on IE.
Overt or Marginal Abruptio Placentae – Separation begins at the edges of the placenta allowing blood to escape from the uterus cavity. Diabetes mellitus can be defined as a disruption of carbohydrate, fat, and protein metabolism resulting from the hyposecretion or inaction of insulin. A little knowledge of kidney physiology is necessary to understand why glycosuria and polyuria occur.


But like any other carrier-mediated transport system, there is a limit to how fast the glucose transporters of the kidney can reabsorb glucose.
In diabetes mellitus, glucose enters the tubules so rapidly that it exceeds the Tm and the tubules cannot reabsorb it fast enough. The readings provided in each test determine the best strategy in managing blood sugar levels.
The authors introduce their discussion as follows: "In this review, we discuss the role tissue iron and elevated body iron stores play in causing type 2 diabetes and the pathogenesis of its important complications, particularly diabetic nephropathy and cardiovascular disease (CVD). According to levels of GGT and ferritin, they were divided into three groups in each gender of each geological location (Urban or Rural), that is, Group 1 (both GGT and ferritin < median values), Group 2 (only GGT or ferritin ? median values), and group 3 (both GGT and ferritin ? median values). The researchers noted, "This is the first prospective study associating ferritin and transferrin with the metabolic syndrome and its components. High and low levels were defined according to the three groups: men, premenopausal women, and postmenopausal women (DESIR). The investigators stated aim was "to determine, in a cohort of men and women, whether ferritin and transferrin were associated with glucose metabolism and whether they were predictive of the onset of hyperglycemia (impaired fasting glycemia or type 2 diabetes) after 3 years of follow-up. Geometric mean values of serum ferritin are shown for premenopausal women (black bar), postmenopausal women (white bar), and men (gray bar).
The researches concluded, "This study shows a significant correlation between SF and the presence of IRS criteria in a large representative population.
1 Odds ratios and 95% CIs for the association of clinically raised ferritin (group 5) vs ferritin in the normal range (groups 1–4) with incident diabetes in men and women, with adjustment for factors as stated (described in methods). The investigators, "examined the association between serum ferritin concentration and the risk of diabetes.
Researchers in Sweden "investigated associations of maternal preconceptional and early pregnancy heme and nonheme iron intake with subsequent GDM risk." "We conducted a prospective cohort study of 3,158 pregnant women. Serum ferritin and markers of lipid peroxidation were significantly higher in the obese women. The researchers first noted,"cardiorespiratory fitness (CRF) and physical activity (PA) are inversely related to the occurrence of type 2 diabetes (T2D). At that time it was noted that, "Excess hepatic iron may occur in insulin resistance-associated iron overload (IRHIO), characterized by hyperferritinemia with normal to mild increases in transferrin saturation.
Iron reduction using phlebotomy significantly reduced oxidative stress in NASH patients and resulted in concomitant reduction in liver serum transferase. Sixty-five patients with high ferritin concentrations, similar to hemochromatosis, but normal transferrin saturation, unlike hemochromatosis. In patients with iron overload of more than 50% above the upper-normal threshold, greater liver damage was noted (including advanced hepatic fibrosis),and a diagnosis of NASH. They attribute the process to enhanced expression of transferrin receptors and hyperdynamic state of retinoid (vitamin A) metabolism. These includes diabetes mellitus, problems of the reproductive tract, exposure to radiation and infection and endocrine disturbances. Diagnosis is made retrospectively by finding an organized blood clot or a depressed area on a delivered placenta.
This is the world's most prevalent metabolic disease, and is the leading cause of adult blindness, renal failure, gangrene, and the necessity for limb amputations.
These are the genitals of a baby girl with AGS, masculinized by prenatal hypersecretion of adrenal androgens. In addition, we emphasize that iron overload is not a prerequisite for iron to mediate either diabetes or its complications.
Odds ratios for T2D in group 2-3 compared with group 1 were analyzed by multiple logistic regressions.
Among 360 new cases of diabetes, serum ferritin measured the study baseline was higher in cases than in controls (in men 96.6 vs. Ferritin serves as an antioxidant by binding excess iron, and elevated serum ferritin is a well-established risk factor for future type 2 diabetes. The green, yellow, and pink regions correspond to the low-, medium-, and high-risk strata, respectively.
The figure shows the incidence rate of diabetes for male study participants in the four serum ferritin (SF) level quartiles.
Note that the subjects with hereditary hemochromatosis (HH) have significantly higher ferritin and transferrin saturation levels than the subjects with NAFLD and high iron. Multivariate regression showed that diabetes, serum ferritin concentrations, body mass index (BMI) and AST were independently associated with NASH." The researchers concluded, "Serum ferritin concentrations and BMI are strongly associated with fibrosis, portal and lobular inflammation in NAFLD patients. OR and 95% confidence interval (CI) for metabolic syndrome (A), type 2 diabetes (B), and IFG (C) according to joint classification of ferritin and CRP concentrations. OR and 95% confidence interval (CI) for type 2 diabetes according to joint classification of metabolic syndrome (MetS) and ferritin concentrations.
The research team stated that ferritin levels elevated to this degree are "an independent predictor of advanced hepatic fibrosis among patients with NAFLD." The researchers concluded, "(Serum ferritin 50% or more above the upper normal laboratory range) is associated with hepatic iron deposition, a diagnosis of NASH, and worsened histologic activity and is an independent predictor of advanced hepatic fibrosis among patients with NAFLD.
The routine problems are normal complications, and pose no significant danger to either the woman or the fetus.
We can add to this list three clinical signs revealed by blood and urine tests: hyper-glycemia31 (elevated blood glucose), glycosuria32 (glucose in the urine), and ketonuria (ketones in the urine). Normally, the kidney tubules remove all glucose from the filtrate and return it to the blood, so there is little or no glucose in the urine of a healthy person.
Note the fusion of the labia majora to resemble a scrotum and enlargement of the clitoris to resemble a penis.


Glucose and ketones in the tubules also raise the osmolarity of the tubular fluid and cause osmotic diuresis—water remains in the tubules with these solutes, so large amounts of water are passed in the urine. The results showed "(1) The prevalence of glucose abnormalities increased across the three groups of female subjects.
The line through the box is the median, and the error bars are the 5th and 95th percentiles.
Of these, 607 remained for analyses after exclusion of participants with missing data or abnormal glucose levels at baseline. Elevated iron stores, reflected in elevated plasma ferritin levels, may induce baseline metabolic abnormalities that ultimately result in diabetes. The results from the study were adjusted using Bayes’ law to reflect the observed 5-year incidence of 5.7% among the 3,032 at-risk individuals in Inter99 (A).
Pooled logistic regression was used to estimate the relative risk (RR) of GDM by quintiles of iron intake controlling for dietary and nondietary risk factors." "Dietary heme iron intake was positively and significantly associated with GDM risk. Increased SF concentration is considered a contributing factor for developing T2D." The researchers "investigated 5,512 adult participants enrolled in the Aerobics Center Longitudinal Study (ACLS) between 1995 and 2001. HH patients are not protected from high levels of iron, yet they generally do not load macrophage iron and tend to have significantly lower levels of triglycerides and LDL cholesterol. Adjusted for age, sex, region, residence, BMI, smoking, drinking, physical activity, education levels, dietary factors, and family histories of chronic diseases (A) or family histories of diabetes (B and C). The ORs were adjusted for age, sex, region, residence, BMI, smoking, drinking, physical activity, education levels, dietary factors, and family histories of diabetes. Furthermore, elevated SF is independently associated with higher NAS (a fibrosis scoring system), even among patients without hepatic iron deposition. The cohort included a high prevalence of (HFE) compound heteroyzgotes who had slightly greater iron burden.
Water follows the glucose and other solutes by osmosis, so the tubules also reclaim most of the water in the filtrate. Some meters can store successive results electronically to help in determining the glucose patterns of clients.Related PhysiologyGlucose is important for cell metabolism.
Correspondingly, MDA levels (a lipid peroxidation product) were also higher in group 3 than other groups.
Significance levels were determined by the Mann–Whitney U-test and are indicated in the figure.
The increased risk of newly diagnosed diabetes was concentrated among participants with transferrin saturations < 45%. On the left axis, absolute risk is indicated, and relative risk is shown on the right axis. Diabetics often pass 10 to 15 L of urine per day, compared with 1 or 2 L in a healthy person. All multiple linear regression coefficients between ferritin concentration and concentrations of insulin, glucose, and glycosylated hemoglobin were positive and significant for both men and women." The investigators concluded, " "Elevated serum ferritin concentration was associated with an increased risk of diabetes. After adjusting for confounders, women reporting the highest heme iron intake levels (?1.52 vs. Diabetes SustenanceGet All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. The researchers concluded, "GGT and ferritin were correlated with each other, and had synergistic effect on the risk of T2D in women.
In more recent research reported on this page and on our Iron Reduction Therapy page the condition of relatively normal transferrin with elevated ferritin has been shown to be a combination of moderate iron overload accompanied by inflammation.
This combination of factors has been described in other conditions including non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), and insulin resistant hepatic iron overload (IR-HIO). Stratification of the at-risk Inter99 subpopulation by fasting plasma glucose status (B) and by DRS risk stratum (C). Conclusion: Lower SF concentration was associated with lower risk of developing T2D in those regularly participating in CRF. Most of the research on the remainder of this page and in our other Science Library pages is focused on the independent predictive value of either ferritin or GGT in relation to diabetes, heart disease and other diseases of aging.
Also, Health-e-Iron concurs with the recommendation that regular fitness activities will lower serum ferritin, but suggests that in conjunction with a fitness routine, participants should consider blood donation or therapeutic phlebotomy as an effective way to more quickly reduce and maintain optimal ferritin levels. Unfortunately, not many people who commit to a regular fitness routine are able to maintain it for more than a relatively short period of months or years. Position lancet to the side of the client’s fingertip, perpendicular to the lines of the fingerprints. The entire patch should be covered.After the blood sample is collected, pressure should be applied to the puncture site to prevent painful extravasation of blood into subcutaneous tissues. Protect the strips from light, heat and moisture.Avoid selecting cold, cyanotic or swollen puncture sites to ensure adequate blood sample.
SHARE Facebook Twitter tweetDaisy AbastarDaisy Abastar holds a degree in Bachelor of Science in Nursing. Her work experiences include Nursing Local Board Examination Reviewer, Clinical Instructor, NC2 Examination Reviewer and Caregiver Lecturer. Her written works are combined learning from theoretical to actual nursing background and ongoing research.



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