Endocrine Abstracts

JOINT2397

Introduction: The mechanisms of abnormal glucose homeostasis in children with transfusion dependent thalassemia (TDT) are complex and multifactorial.

Objective: To assess the prevalence and spectrum of deranged glucose metabolism in children with TDT in comparison with age and sex matched controls.

Methods: Cross-sectional analytical study conducted in 110 children (aged 5-18 years) with TDT (cases) and equal number of age and sex matched controls. Proportion of children with deranged fasting blood glucose and fasting insulin levels were assessed in both cases and controls. Impaired glucose tolerance and insulin resistance were evaluated using oral glucose tolerance test (OGTT) and Homeostatic model assessment of insulin resistance (HOMA-IR) levels respectively in children with TDT.

Results: Altered glucose metabolism was observed in 33.6% children with TDT. Prevalence of impaired fasting glucose (IFG), impaired glucose tolerance and diabetes was 31.8%, 5.45% and 1.8% respectively. Proportion of children with IFG [31.8% vs 0], fasting insulin deficiency [19% vs 5.5 %] and raised HOMA-IR [17.3% vs 1.82%] were higher in cases as compared to controls (P<0.001). The mean fasting glucose, fasting insulin, 30-minute insulin on OGTT and HOMA-IR were significantly higher in children with TDT and altered glucose metabolism than with normal glucose tolerance (table 1). Significant predictors of altered glucose metabolism in TDT cases were delayed puberty, raised ALP and high BMI for age.

Conclusions: 1/3rd of children with TDT had altered glucose metabolism. Underlying mechanisms include both insulin resistance and insulin deficiency.