ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
Evolution of combined impaired fasting glucose and impaired glucose tolerance in 58 β-thalassemia major (β-TM) patients during a mean 7.7 year follow-up
Vincenzo De Sanctis 1 , Shahina Daar 2 , Ashraf Soliman 3 , Ploutarchos Tzoulis 4 , Mohamed Yassin 5 & Christos Kattamis 6
1Quisisana Hospital, Ferrara, Italy; 2College of Medicine, Sultan Qaboos University, Muscat, Oman; 3Hamad Medical Center, Pediatrics, Doha, Qatar; 4Department of Diabetes and Endocrinology, Whittington Hospital, London, United Kingdom; 5Hamad Medical Center, Hematology, Doha, Qatar; 6National Kapodistrian University of Athens, First Department of Paediatrics, Athens, Greece
Background: In patients with β- thalassemia major (β-TM) glucose dysregulation (GD) develops insidiously, aggravating prognosis and 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 (DM) and to analyze the progression to DM or regression to normal glucose tolerance test (NGT).
Method: 58 β-TM patients were followed for a mean duration of 7.7 years with annual or biennial OGTT. Glucose and insulin data were analysed.
Results: During the follow-up, FPG and 2-h PG levels after OGTT reverted to NGT in 13 (22.4%), deteriorated to DM in 13 (22.4%) and did not change in 32 (55.2%). A significant correlation was observed between FPG and ALT level (r: 0.3158; P:0.01) and between chronological age and serum ferritin (SF) level (r: -0.321; P:0.014). Both SF and ALT at the baseline and at the time of last observation, were independent predictors of evolution to diabetes mellitus.
| Patient’s groups | Age (yrs) at diagnosis of IFG+IGT | SF (ng/ml) at diagnosis of IFG+IGT | ALT (U/l) at diagnosis of IFG+IGT | SF peak (ng/ml) | Duration of follow-up (yrs) | SF at last observation (ng/ml) | BMI at last observation |
| Group A: From IFG+ IGT to β-TM-RD (13 patients) | 21.0 ± 7.5 | 3467.7 ± 2089.2 | 104.1 ± 82.0 | 4676.5± 1758.8 | 4.8 ± 4.1 | 2519.1 ± 1641.6 | 23.9 ± 5.4 |
| Group B: From IFG+ IGT to NGT (13 patients) | 21.3 ± 6.4 | 1319.6 ± 608.8 | 59.3 ± 31.7 | 2858.6± 1163.8 | 8.6 ± 4.0 | 1219.3 ± 802.7 | 23.1 ± 2.7 |
| Group C: From IFG/IGT to PP (32 patients) | 19.8 ± 5.8 | 2071.8 ± 1646.2 | 54.7 ± 36.6 | 4071.4± 1451.2 | 8.8 ± 5.0 | 1251.7 ± 835.5 | 22.5 ± 2.6 |
| Group A vs. B: P value | NS | 0.001 | NS | 0.004 | 0.02 | 0.017 | NS |
| Group A vs. C: P value | NS | 0.021 | 0.01 | NS | 0.01 | 0.001 | NS |
| Group B vs. C: P value | NS | NS | NS | 0.01 | NS | NS | NS |
| Abbreviations= SF: Serum ferritin; ALT: Alanine aminotransferase; BMI: Body Mass Index: PP: persistent prediabetes (IFG, IGT, combined IFG/IGT). | |||||||
Conclusion: The combination IFG/IGT in β-TM patients with severe iron overload constitutes a high-risk state for developing diabetes.
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