ECE2022 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (202 abstracts)
When and How to Screen for Glucose Dysregulation (GD) in patients with β-Thalassemia Major (β-TM): A retrospective study by The International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine (ICET-A)
Vincenzo De Sanctis 1 , Ashraf Soliman 2 , Shahina Daar 3 , Ploutarchos Tzoulis 4 , Mehran Karimi 5 , Salvatore Di Maio 6 & Christos Kattamis 7
1Quisisana Hospital, Ferrara, Italy; 2Hamad Medical Center, Pediatrics, Doha, Qatar; 3College of Medicine, Sultan Qaboos University, Muscat, Oman; 4Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UK;, United Kingdom; 5Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Shiraz, Iran; 6Children’s Hospital ‘Santobono-Pausilipon’, Pediatrics, Naples, Italy; 7National Kapodistrian University of Athens 11527, Greece, Pediatrics, Athens, Greece
To investigate the best criteria and time to diagnose dysglycemia in β-TM patients, the ICETA performed a retrospective study on glycemic abnormalities (GD) in 397 with β-TM patients (aged 5–40 years; 56.3% males) followed between 1988 to 2021 in a single centre (by VDS) (40 years).
Methods: Fasting blood glucose (FPG) and standard oral glucose tolerance test (OGTT) results were collected over 40 years of follow up and results were categorized following ADA and WHO criteria.
Results: Based on the FPG data, using the ADA criteria, the prevalence of isolated IFG was 23.6 %, while increasing the threshold value of FPG to 110 mg/dl according to WHO criteria, decreased the prevalence to 15.3%. β-TM patients showed a higher prevalence of GD mainly in the second to third decade of life. Based on the OGTT, 44 of 234 β-TM patients presented with IFG (18.8%), 3 (1.2%) with IGT and 1 with a new diagnosis of thalassemia related DM (Th-RD). In patients with IFG the probability of diagnosing IGT was higher (46.1%) in subjects with FPG between 100 and 109 mg/dl compared to subjects with FPG between 110 and 125 mg/dl (P=0.0071). Both ADA and WHO criteria for IFG missed the diagnosis of Th-RD in 4 of 91 patients (4.3%) and 11 of 59 patients (18.6%), respectively. The number of patients with a new diagnosis of diabetes, after OGTT, increased progressively starting from the age of 11 years (Table).
| (FPG) | 5–10 years N (%) | 11–20 years N (%) | 21–30 years N (%) | 31–40 years N (%) |
| FPG < 100 (mg/dl) (n=40) | 0/63 (0 %) | 0/78 (0 %) | 0/53 (0 %) | 3/40 (7.5%) |
| IFG low: 100–109 mg/dl (n=33) | 0/11 (0 %) | 0/47 (0 %) | 2/19 (10.5%) | 2/14 (14.2%) |
| IFG high: 110–125 mg/dl (n=55) | 0/4 (0 %) | 1/25 (4%) | 6/23 (26.0%) | 4/7 (57.1%) |
| New Th-RD PG after OGTT: ≥ 200 mg/dl | 0/78 (0 %) | 1/150 (0.6 %) | 8/95 (8.4 %) | 9/61 (14.7 %) |
Conclusion: Many β-TM patients who have a normal FPG may present with GD after OGTT. Dysglycemia may occur in very young patients. OGTT screening seems to be cost-effective. ADA criteria used for the diagnosis of IFG identified an additional group of patients with dysglycemia. Diagnostic value of FPG and OGTT in detecting Th-RD in 384 patients with β-TM aged 5–40 years.
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Endocrine Abstracts
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