Abnormal Glucose Tolerance in Transfusion-Dependent Beta- Thalassemic Patients

Abstract

OBJECTIVE- To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent beta- thalassemic patients. RESEARCH DESIGN AND METHODS- A total of 89 transfusion-dependent beta- thalassemic patients were interviewed. Diabetes was previously diagnosed in 14 of them . In the remaining 75 patients, 68 participated in an oral glucose tolerance test. Potential risk factors were identified using the independent t test, X2 test, and Fisher 's exact test. Logistic regression analysis was used to select the independent risk factors that best predicted abnormal glucose tolerance. A two-tailed P value of <0.05 was considered to be statistically significant. RESULTS- The prevalence of impaired glucose tolerance was 8.5% (7 of 82) and that of diabetes was 19. 5% (16 of 82). Presentation with diabetic ketoacidosis was 31.1% (5 of 16) . The risk factors for abnormal glucose tolerance found in transfusion- dependent beta-thalassemic patients were serum ferritin concentration and hepatitis C infection. CONCLUSIONS- The interaction of iron overload and hepatitis C infection worsened the prognosis of thalassemic patients. Aggressive iron-chelation therapy as well as prevention and treatment of hepatitis C infection should be mandatory in managing glucose homeostasis in transfusion-dependent beta- thalassemic patients in Taiwan.