Diabetes and Metabolic Syndrome

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Survivors of HSCT may be at risk for insulin resistance, impaired glucose tolerance and type II diabetes [45]. Risk factors relevant to the development of these problems include obesity, family history of diabetes, inactivity, diet, use of growth hormone and race. In one study of 748 patients evaluated for type II diabetes, 34 had developed this condition at a median follow-up of 11 years. The prevalence of type II diabetes was 9 % among the survivors of leukemia, with CML patients at highest risk [15]. The prevalence was age-related, with 12% occurring among leukemia

Table 17.2. Organ systems: suggested follow-up survivors 20-39 years old and 43 % occurring among survivors 40-49 years [15]. The prevalence of diabetes type I, although less common, was three times higher than in the general population. Most patients evaluated were not obese and experienced a relatively early onset of type II diabetes. Racial minorities were more likely to develop diabetes; TBI was not a risk factor in this analysis.

Hyperinsulinemia and hypertriglyceridemia [45] have been described post HSCT. Therefore, post-HSCT patients, particularly those who were treated for leukemia, merit close observation for the development of diabetes, as well as lipid abnormalities.

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