The different patterns of insulin response during Oral Glucose Tolerance Test (OGTT) in transfused young  patients  with β-Thalassemia. : Insulin response patterns during OGTT in thalassemia

Christos Kattamis; Vassilis Ladis; Myrto Skafida; Nicoletta Iacovidou; Charalambos Theodoridis

doi:10.23750/abm.v92i4.11144

The different patterns of insulin response during Oral Glucose Tolerance Test (OGTT) in transfused young patients with β-Thalassemia.

Insulin response patterns during OGTT in thalassemia

Authors

Christos Kattamis Thalassemia Unit, First Department of Pediatrics, National and Kapodistrian University of Athens , “Aghia Sophia” Children Hospital, Athens Greece
Vassilis Ladis Thalassemia Unit, First Department of Pediatrics, National and Kapodistrian University of Athens , “Aghia Sophia” Children Hospital, Athens Greece
Myrto Skafida Aghia Sophia Children's Hospital, Athens, Greece
Nicoletta Iacovidou Deparment of Neonatalogy, Medical School, National and Kapodistrian University of Athens, Aretaieo Hospital, Athens Greece
Charalambos Theodoridis Endocrinology Unit “Aglaia Kyriakou” Children Hospital Athens Greece.

DOI: https://doi.org/10.23750/abm.v92i4.11144

Keywords:

b-thalassemia, glucose metabolism, OGTT, Insulin resistance

Abstract

Background and aim. Dysregulation of glucose metabolism is a common complication of transfusions in Transfusion Dependent Thalassemia (TDT) patients. For early diagnosis of glucose disturbances, screening is recommended. The age of starting and the type of screening vary; the more common methods are assessment of RPG, FPG, 2h PG and 2 hours OGTT. The combined assessment of glucose tolerance and insulin response during OGTT is rarely recommended. The main objective of the study is the evaluation of simultaneous assessment of Glucose Tolerance (GT) and Insulin Response (IR) during OGTT in patients with TDT.

Methods. 43 TDT patients aged 12-28years, without clinical evidence of glucose disturbances, were randomly selected for the study. The 2-hour OGTT in 30 minutes intervals was applied. Plasma glucose and insulin were assessed in all samples using routine laboratory methods.

Results. Of 43 patients 31(72%) had Normal GT; of them 9 (29%) had normal insulin response (NIR), 14 (45%) high IR and 8(26%) delayed peak IR. Delayed peak IR was found in 8 of the 9 patients with Impaired GT and in 2 of the 3 with diabetic GT. Deficient IR (hypoinsulinemia) was found in two patients.

Conclusions. Simultaneous assessment of GT and IR during OGTT in TDT patients, seems to be a most sensitive and creditable screening test for early diagnosis of glucose disturbances. High IR and delayed peak IR in normoglycemic patients are valuable indices for diagnosis of the pre-diabetic state that precede the development of glucose disturbances in TDT patients and start proper follow and management.

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