What Men with Hemophilia Need to Know About Diabetes
Recent studies have found that older men with hemophilia have a higher risk of diabetes than those without the bleeding disorder.
An estimated 37.3 million people in the U.S. have diabetes, and about one-quarter of them don’t know they have the disease, the Centers for Disease Control and Prevention reports.
According to two studies published in the journal Haemophilia in 2022, older men with hemophilia are at a higher risk of developing diabetes than men who don’t have the bleeding disorder. Here’s what you need to know.
What the Studies Showed
One study by a team of researchers in California, Washington, and Canada examined the risk of diabetes for men with hemophilia compared with men from the general U.S. population and outpatients at a Veterans Affairs medical clinic.
The researchers found that while young men with hemophilia are less likely to develop diabetes than the general male population, the opposite is true for men in their 60s and older, especially if they also have hepatitis C.
Infection with the hepatitis C virus is a known risk factor for developing diabetes — the virus is thought to interfere with the body’s ability to regulate blood sugar levels. Many older men with hemophilia became infected with hepatitis C in the 1970s and ’80s after being exposed to virally contaminated clotting products.
The study findings inform clinical practice, the authors conclude, since hemophilia treatment centers are the medical home for many patients with hemophilia. Providers caring for people with hemophilia should intensify diabetes screening in patients ages 60 and older, especially when they also have hepatitis C, the authors advise.
Another study, by researchers at the CDC and the University of Vermont, examined the prevalence of diabetes and other age-related conditions among older men with hemophilia receiving care at hemophilia treatment centers compared with men in the general population.
The researchers looked at the medical records of 2,237 men ages 45 and older with hemophilia and found they had a higher prevalence of diabetes (as well as anxiety and depression) than men in the general U.S. population. While 15.8% of men in the general population had diabetes, that figure was 24% for those with hemophilia.
What Is Diabetes?
Diabetes is a disease that occurs when the body can’t properly use and store glucose. When you eat food, your body breaks down most of it into sugar (glucose) and releases it into your bloodstream. When your blood sugar rises, this signals the pancreas to release insulin. Insulin acts like a key, allowing blood sugar into your body’s cells to be used as energy.
There are two main types of diabetes: type 1 and type 2. With type 1 diabetes, which usually develops in children and young adults, the body stops making insulin. People with type 1 diabetes must take daily insulin injections or use an insulin pump to survive. About 5% to 10% of people with diabetes have type 1.
Type 2 diabetes, which accounts for the other 90% to 95% of diabetes cases, is sometimes called adult-onset diabetes. It most often occurs in people older than 45, although more and more children and young adults are being diagnosed with it. With type 2 diabetes, the body produces insulin, but the cells in the body are unable to respond to it, which is called insulin resistance. When too much blood sugar stays in a person’s bloodstream, it can cause serious health problems, such as heart disease, kidney disease, and vision loss.
The main risk factors for type 2 diabetes are age (45 or older); being overweight; having a parent, brother, or sister with type 2 diabetes; being physically active less than three times a week; having had gestational diabetes (diabetes during pregnancy) or having given birth to a baby who weighed over 9 pounds; and being an African American, Hispanic or Latino, American Indian, or Alaska Native person. (Some Pacific Islanders and Asian American people are also at higher risk.) The American Diabetes Association has a 60-second risk test you can take online.
The symptoms of type 2 diabetes are:
- Frequent urination, especially at night
- Excessive thirst
- Losing weight without trying
- Extreme hunger
- Blurry vision
- Numbness or tingling in the hands or feet
- Very dry skin
- Sores that heal slowly
- Having more infections than usual
Making the Diagnosis
If you have symptoms or risk factors for type 2 diabetes, talk to your primary care doctor or hematologist about being tested for the disease. Several blood tests can confirm the diagnosis:
- An A1C test measures your average blood sugar level over the past two or three months.
- A fasting blood sugar test measures your blood sugar after an overnight fast.
- A glucose tolerance test measures your blood sugar before and after you drink a liquid that contains glucose.
Source: National Hemophilia Foundation, Hemaware
Photo: Courtesy of Vecteezy.com