European Journal of Pediatrics

, Volume 167, Issue 8, pp 873–876

Prevalence of impaired glucose metabolism in β-thalassemic children receiving hypertransfusions with a suboptimal dosage of iron-chelating therapy

  • Somchit Jaruratanasirikul
  • Rarong Chareonmuang
  • Malai Wongcharnchailert
  • Vichai Laosombat
  • Pasuree Sangsupavanich
  • Kalaya Leetanaporn
Original Paper

DOI: 10.1007/s00431-007-0602-0

Cite this article as:
Jaruratanasirikul, S., Chareonmuang, R., Wongcharnchailert, M. et al. Eur J Pediatr (2008) 167: 873. doi:10.1007/s00431-007-0602-0

Abstract

A cross-sectional study of impaired glucose metabolism was carried out in 48 β-thalassemic patients receiving hypertransfusions. An oral glucose tolerance test (OGTT) was performed using the method and criteria of the American Diabetes Association (ADA). Diabetes mellitus was diagnosed in two patients, and impaired glucose tolerance was found in four patients, giving a prevalence of impaired glucose metabolism of 12.5% in our patient population. The significant clinical characteristics associated with the diagnosis of impaired glucose metabolism were wasting (−2.15/−0.86 SDS, p = 0.025), stunting (−2.69/−1.22 SDS, p = 0.03), higher ferritin levels (8679/4710 μg/L, p = 0.005), splenectomy (50/9.5%, p = 0.012), and lower area under curve (AUC) of insulin secretion after OGTT (40.0/77.7, p = 0.002). The significant decrease of AUC insulin in thalassemic patients with an impaired glucose tolerance test suggests that the pathogenesis may originate from pancreatic β-cell damage rather than from insulin resistance. In conclusion, the prevalence of impaired glucose tolerance in our population of thalassemic patients receiving hypertransfusions with suboptimal iron chelating therapy was 12.5%. The clinical characteristics of thalassemic patients who developed impaired glucose tolerance were wasting, stunting, higher ferritin levels, splenectomy, and lower AUC insulin.

Keywords

Diabetes mellitus Glucose metabolism Impaired glucose tolerance Thalassemia 

Abbreviations

ADA

American Diabetes Association

DM

diabetes mellitus

IFG

impaired fasting glucose

IGT

impaired glucose tolerance

NGT

normal glucose tolerance

OGTT

oral glucose tolerance test

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Somchit Jaruratanasirikul
    • 1
  • Rarong Chareonmuang
    • 1
  • Malai Wongcharnchailert
    • 1
  • Vichai Laosombat
    • 1
  • Pasuree Sangsupavanich
    • 2
  • Kalaya Leetanaporn
    • 3
  1. 1.Department of Pediatrics, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
  2. 2.Epidemiology Unit, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand
  3. 3.Department of Nuclear Medicine, Faculty of MedicinePrince of Songkla UniversityHat YaiThailand

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