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Evolution of glucose intolerance and diabetes in transfused patients with thalassemia
Christos Kattamis1, Vassilis Ladis, Dimitrios Tsoussis
1Thalassemia Unit, First Department of Pediatrics, Athens University, Agia Sophia Children's Hospital, Athens, Greece. ckattamis@cc.uoa.gr
Objective:
To study the evolution of glucose disturbances (GD) in patients with thalassemia aged 11-30 years.
Design And Methods:
A total of 263 patients, classified into three groups on the basis of age, and period of follow-up ranging from 2-10 years, were studied. Evolution of GD was assessed through serial oral glucose tolerance tests (OGTT), based on WHO criteria.
Results:
At baseline (11-14 years of age) evaluation of OGTT disclosed a prevalence of 16.3% of impaired glucose tolerance (IGT), and zero for diabetic tolerance (DT). Prevalence of IGT increased progressively up to 39% in the following 4 years, but remained constant during the last 6 years of observation. In contrast, DT had a very low prevalence, beginning with 0.5% at 13-16 years, increasing to 2.4% by the age of 21-24 years.
Conclusions:
During puberty and early adolescence impaired glucose tolerance (IGT) was found in a considerable proportion of thalassemics. In contrast, DT was infrequent and progression to DM was slow. Only 12.4% of patients with IGT developed DT within a period of 10 years. Further studies are necessary to identify all of the factors contributing to abnormalities of glucose metabolism in thalassemic patients.
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