本文报道1例以糖尿病就诊的继发性血色病(SHC)病例。患者男,58岁,因“多尿、多饮、体重下降1周”入院。既往有贫血、脾大史。查体发现皮肤青灰色、肝大。糖耐量试验确诊糖尿病,胰岛素释放试验提示曲线低平,胰岛功能差。血清铁及铁蛋白升高。肝组织病理提示弥漫分布含铁血黄素颗粒,普鲁士蓝染色阳性。胰岛素治疗及铁螯合剂治疗有效。近一半患者在发现血色病时已发生糖尿病。过量的铁参与氧化应激,形成脂质过氧化物,造成胰岛β细胞衰竭,导致糖尿病。 This article reports a case of diabetic secondary treatment of hemochromatosis (SHC) cases. Male patient, 58 years old, due to “polyuria, polydipsia, weight loss 1 week ” admission. Past anemia, history of spleen. Physical examination found the skin blue-gray, large liver. Glucose tolerance test confirmed diabetes, insulin release test suggests that the curve is low, poor islet function. Serum iron and ferritin increased. Liver histopathology prompted diffuse distribution of hemosiderin particles, Prussian blue staining. Insulin therapy and iron chelator therapy effective. Nearly half of patients develop diabetes when they have hemochromatosis. Excessive iron participates in oxidative stress, forming lipid peroxides, resulting in islet beta cell failure leading to diabetes.