Evolution of Combined Impaired Fasting Glucose and Impaired Glucose Tolerance in β-Thalassemia Major: Results in 58 Patients with a Mean 7.7- year Follow-Up: Evolution of prediabetes in β-Thalassemia Major

Evolution of Combined Impaired Fasting Glucose and Impaired Glucose Tolerance in β-Thalassemia Major: Results in 58 Patients with a Mean 7.7- year Follow-Up

Evolution of prediabetes in β-Thalassemia Major

Authors

  • Vincenzo De Sanctis Quisisana Hospital, Ferrara
  • Shahina Daar Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
  • Ashraf T Soliman Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children’s Hospital, Alexandria, Egypt
  • Ploutarchos Tzoulis Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UK
  • Mohamed A. Yassin National Center for Cancer Care and Research, Medical Oncology Hematology Section HMC, Doha, Qatar
  • Christos Kattamis First Department of Paediatrics, National Kapodistrian University of Athens 11527, Greece

Keywords:

β- thalassemia major, prediabetes, combination IFG/IGT, follow-up, iron overload, liver enzymes

Abstract

Abstract. Background: Advances in β- thalassemia major (β-TM) care have transformed a disease which had previously led to an early childhood death into a chronic condition. With increased lifespan, comorbidities associated with the disease have become more common, among them glucose dysregulation (GD) which develops insidiously, aggravating prognosis and patients’ quality of life. Objectives: The objectives of this study were to retrospectively review the extent to which β-TM patients, having combined impaired fasting glucose (IFG) and impaired glucose tolerance test (IGT) on oral glucose tolerance test (OGTT), progressed to diabetes and to analyze the potential determinants inducing this progression, or regression to normal glucose tolerance test (NGT). Research design and method: Data of 58 β-TM patients, followed for a mean duration of 7.7 years (range: 1-20 years) with annual or biennial OGTT, were retrieved. Insulin release and insulin sensitivity (IS) were also analyzed. Results: During the follow-up, FPG and 2-h PG levels after OGTT reverted to NGT in 13 patients (22.4%), deteriorated in 13 patients (22.4%) who developed diabetes mellitus, and did not change in the remaining 32 patients (55.2%). A significant correlation was observed between FPG and ALT level (r: 0.3158; P:0.01) and an inverse correlation was found between chronological age and serum ferritin (SF) level (r: -0.321; P:0.014). Finally, SF and ALT, both at the baseline and at the time of last observation, were independent predictors of evolution to diabetes mellitus. Conclusion: The combination IFG/IGT in β-TM patients with severe iron overload constitutes a high-risk state for developing diabetes.

References

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01-07-2022

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1.
Evolution of Combined Impaired Fasting Glucose and Impaired Glucose Tolerance in β-Thalassemia Major: Results in 58 Patients with a Mean 7.7- year Follow-Up: Evolution of prediabetes in β-Thalassemia Major . Acta Biomed [Internet]. 2022 Jul. 1 [cited 2024 Mar. 29];93(3):e2022242. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/12825