Abnormal Glucose Tolerance in Transfusion-Dependent β-Thalassemic Patients

Abstract

OBJECTIVE—To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent β-thalassemic patients. RESEARCH DESIGN AND METHODS—A total of 89 transfusion-dependent β-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, χ2 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 β-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 β-thalassemic patients in Taiwan.