The prevalence of hereditary haemochromatosis in a diabetic population

Hereditary haemochromatosis is an under-diagnosed and treatable cause ofchronic liver disease. Its prevalence indicates that selective populationscreening may be worthwhile, but opinion differs as to whether diabeticpatients constitute such a group. We studied 727 patients attending ateaching hospital diabetic clinic. On first testing, 7.4% had abnormallyhigh iron indices, but only 3% remained abnormal on retesting. Of thesepatients, those at high risk were offered liver biopsy for histologicalassessment and iron assay. Only one had hereditary haemochromatosis, butall had abnormal liver histology--largely steatosis but some with fibrosis.These findings raise questions regarding the true prevalence of thisdisorder in North- East England, do not indicate that targeted screening ofdiabetic patients is worthwhile, and incidentally highlight the potentialimportance of diabetes as a cause of liver disease.