Iron and diabetes

Iron can affect the pancreas — the gland that makes insulin — so people with thalassaemia have a higher chance of developing diabetes, usually in the teens or later. Good chelation is the best prevention.

It’s screened for regularly (often a glucose tolerance test from around age 10). Note that HbA1c is unreliable after transfusions, so teams use other tests such as fructosamine or a glucose tolerance test instead.

If diabetes does develop, it’s very manageable — and catching it early keeps it mild.