ESPE Abstracts (2015) 84 P-2-267

Glycaemic Dysregulation in Transfusion Dependent Thalassaemia Patient in a Children's Hospital

Song Hai Lim, Wilkins Lim & Thian Lian Soo

Sabah Women and Children’S Hospital, Kota Kinabalu, Malaysia

Background: Thalassaemia patients are at risk of developing diabetes mellitus (DM) and pre-diabetes status predominantly due to iron overloading. The prevalence is 20–30% in adult patients. Age, serum ferritin, T2* magnetic resonance imaging (MRI) of the heart and pancreas volume has been found to be associated with DM. However, majority of the studies involved more adults than children.

Objective and hypotheses: To establish the prevalence of glucose dysregulation in a group of Thalassaemia children, and to determine factors associated with development of this condition.

Method: A cross-sectional study whereby all Thalassaemic children 12 years old and above by 31 January 2015 were enrolled. These children had annual blood screening for endocrinopathy, and also regular ferritin monitoring. Cardiac T2* MRI was done at least once in every 2 years. Their medical records were reviewed to extract the latest glucose levels, cardiac T2* MRI value, and calculate mean annual ferritin level. DM and pre-diabetes are diagnosed based on standard oral glucose tolerance test following WHO criteria.

Results: There are total 55 children (41.8% female) fulfilled the criteria. The mean age was 14.0 years old. There are five DM and three pre-diabetes detected, making prevalence of glucose dysregulation in this cohort was 14.5%. Affected children were significantly older (mean 14.8 vs 13.9 years old, P=0.022), with higher ferritin level (median 11 224.5 vs 2 842.5 ng/ml, P=0.049) and lower cardiac T2* MRI (median 5.82 vs 21.20 ms, P=0.009). Puberty status was not significantly different between the groups (P=0.592).

Conclusion: Prevalence of glycaemic dysregulation is high even in paediatric thalassaemia patients. Older age, higher ferritin and lower cardiac T2* MRI are associated with development of this condition.

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