Background: Continuous Glucose Monitoring (CGMS) is a useful method to detect the variability of glucose fluctuations and offers the opportunity for better assessment of glucose homeostasis in TM patients and response to therapy.
Objective and hypotheses: Does real-life monitoring of blood glucose add to the therapeutic approach to patients with TM who have glycemic abnormalities?
Method: In two thalassemic adolescents with glycemic abnormalities we tested the benefit of monitoring blood glucose to support the therapeutic decision.
Results: A 15 year old male with TM presented with nocturia. His FBG was 5.6 mmol/l and OGTT showed a BG level at 2 h of 8.5 mmol/l. His CGMS showed a diabetic range of BG after dinner and overnight. Based on this tracing, a basal insulin (Glargine) was prescribed at night. A satisfactory response was recorded by CGMS. In addition, a 14 year old girl with TM with no symptoms related to glycemic abnormalities. Her FBG was 4.9 mmol/l and an OGTT showed a BG level at 2 h of 6.9 mmol/l (IGT). CGMS tracing showed prolonged persistent hyperglycemia after lunch suggesting a need for prandial insulin to cover her carbohydrate load. Insulin aspart before lunch properly controlled her glycemia.
Conclusion: Our results demonstrate that the CGMS is a useful method to detect the variability of glucose fluctuations and offers the opportunity for better assessment and control of glucose homeostasis in TM patients.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology