ESPE Abstracts

Background: Abnormalities in glucose homeostasis are fairly common complications in thalassemia major (TM) patients. This study aimed at determining the incidence of diabetes mellitus (DM) and studying the potential factors responsible for secondary DM of TM patients.

Objective and hypotheses: A total of 54 (33 male) transfusion-dependent TM patients were in the ‘TM group ’; 25 age- and gender-matched healthy children were recruited as the ‘control group’.

Method: The height, weight, fast blood glucose (FBG) and insulin level, serum ferritin (SF), superoxide dismutase (SOD) and ultrasensitive C-reactive protein (hsCRP) were evaluated in all subjects. Insulin resistance index (IRI) and β cell function index (BFI) were also estimated.

Results: The mean age was 10.35±4.3 years. The SF level of the TM group was 3302.3±2431.4 ng/ml. The TM group had significantly higher levels of FBG and IRI than the control group (P=0.018, P=0.022 respectively). There were no statistical differences in insulin level and BFI between two groups. None of the control group had impaired fast glucose or DM. In TM group, the prevalence was 18.5 and 3.7% respectively (P=0.014). The incidence of abnormal glucose occurred since age five and increased obviously after age ten (P=0.029). The incidence of abnormal glucose patients were higher with SF ≧2500 ng/ml than those whose SF were less than 2500 ng/ml (P=0.038). The TM had significantly higher levels of SOD and hsCRP than the control. The level of SOD was well correlated with IRI and BFI.

Conclusion: Insulin resistance happened earlier than abnormal glucose level in TM patients. Age and the degree of iron overload were closely associated with the morbidities. The glucose metabolism should be followed up regularly after age five in TM patients. The free radical content may induce the morbidities.