Isolated increase of plasma glucose levels at 30 minutes during oral glucose tolerance test (OGTT) in young adult patients with transfusion-dependent β-thalassemia (β-TDT): A possible predictor marker for early development of glucose dysregulation (GD)

Vincenzo De Sanctis; Ashraf Soliman; Shahina Daar; Ploutarchos Tzoulis; Christos Kattamis

doi:10.23750/abm.v96i2.16957

Authors

Vincenzo De Sanctis Coordinator of ICET-A Network (International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescence Medicine), Ferrara, Italy
Ashraf Soliman Department of Pediatric Division of Endocrinology, Hamad General Hospital, Doha, Qatar
Shahina Daar Department of Hematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
Ploutarchos Tzoulis Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UK
Christos Kattamis First Department of Pediatrics, National Kapodistrian University of Athens, Greece

Keywords:

Thalassemia,OGTT, glucose dysregulation

Abstract

Background: In the general population, prospective studies have documented that intermediate plasma glucose (PG) at 30-min or 1- hour during a standard oral glucose tolerance test (OGTT) are associated with a high risk of glucose dysregulation (GD) and incidence of diabetes.

Study aims: The main aim of this retrospective observational study was to determine whether high 30-min-PG levels could be an early indicator of GD in β-TDT patients with an otherwise normal glucose tolerance test (NGT).

Patients and Methods: A total of 57 β-TDT young adult patients with normal OGTT were re-evaluated, according to the American Diabetes Association guidelines. Indices of insulin secretion and sensitivity were also calculated. Patients were divided into 3 groups (A, B and C), according to 30-min PG evaluated in percentile.

Results: At last consultation, the number of patients with GD was significantly higher in Group C vs. Group A (12/19 vs. 5/19; P: 0.048). In addition, in Group A, an attenuated mean oral disposition index (oDI₃₀) was observed, suggesting impairment of glucose metabolism. In Group B and Group C, a significant inverse correlation between the insulinogenic index (IGI) vs 2-h PG (r = -0.3480; P = 0.037) and a significant positive correlation between IGI and oDI₃₀ were documented (r = 0.7727; P: < 0.00001).

Conclusions: Young adult β-TDT subjects with NGT and isolated high 30-min PG > 75^th percentile (≥155 mg/dL) may represent a distinct group of patients at a risk for developing GD, likely due to decreased insulin sensitivity and pancreatic β-cell dysfunction.

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