Diabetes Mellitus in Polytransfused Beta-thalassemia Patients.

ABSTRACT: Introduction: Β-Thalassemia is a chronic hereditary hemolytic anemia characterized by a defect of synthesis of beta-globin chains, particularly common in the Mediterranean region, southern Asia, and the Middle East (1). Chelation therapy significantly prolonged the life expectancy of patients (2). This has led to an increase in the prevalence of cardiac, hepatic and endocrine complications, in particular the development of diabetes linked to iron overload (3). Objectives: Describe the frequency of glucose homeostasis abnormalities in patients with polytransfused β-thalassemia and to study the relationship between abnormalities in glycoregulation and : serum ferritin level , duration of transfusion treatment, splenectomy and Compliance with chelation treatment. Method: It is a descriptive, analytical and mono-centric cross-sectional study which was carried out in the department of pediatrics of Mustapha Pacha University hospital and which involved 87 patients (46 Girls and 41 Boys), followed for several years on a regular basis and treated by a transfusion regimen (more than 10 transfusions) combined with a chelating treatment. All patients were assessed by a clinical history, physical examination, fasting blood glucose and Oral Glucose Tolerance Test (OGTT) combined with a test of HOMA-IR (Homeostasis Model Accessment of insulin resistance). Results: Twenty eight (32.2%) patients presented glycoregulation disorders ,with 17 (60.7%) girls and 11 (39.3%) boys, there is no statistically significant relationship between the two genders (p = 0.31). The average age of patients with glycoregulation disorders is 13.4 ± 6.58 years, 16 (18.4%) patients had moderate fasting hyperglycemia , 8 (9.2%) patients had glucose intolerance (GI), and 4 (4.6%) patients had diabetes (3 patients diagnosed before the start of the study). 10 (12%) patients presented a positive HOMA test. There is no statistically significant relationship between ferritinemia and glycoregulation disorders (p = 0.65). Conclusion: Our results suggest that children with β-thalassemia have a high incidence of glycoregulation disorder in the second decade of life or later. KEY WORDS: Diabetes, polytransfused β-thalassemi