Total body irradiation for hematopoietic stem cell transplantation during early childhood is associated with the risk for diabetes mellitus

Hematopoietic stem cell transplantation (HSCT) is a curative treatment for life-threatening malignancies. However, late HSCT adverse effects cause substantial morbidity among long-term survivors. Metabolic complications, such as diabetes mellitus and hyperlipidemia, are the major late effects of pediatric HSCT, but the pathogenesis of these complications is unclear. Different mechanisms leading to insulin resistance have been implicated, including TBI related muscular damage leading to secondary muscular insulin resistance and a chronic systemic inflammatory state.