Abstract

Aim: The life expectancy in patients with ß-thalassemia major has extended considerably after the introduction of hypertransfusion protocols. However, this resulted in an increase of endocrine complicatioris such as glucose intolerance and insulin dependent diabetes. The aim of the study was to evaluate the incidence of insulin dependent diabetes mellitus (IDDM), impaired glucose tolerance (IGT) and associated factors in transfusion dependent ß-thalassemia major patients who had been observed in our hospital. Methods: 33 patient with thalassemia major were chosen for this evaluation. Mean age was 10.8±3.2. Control group consisted of 15 heathy children with mean age 9.8±2.8. Oral glucose tolerance test was applied both for the study group and healthy controls. Blood samples were taken at 0, 60 and 120 minutes and the results were interpreted according to the criteria published by World Health Organisation. The glucose values of thalassemia group and healthy controls were eualuated with Student-t statistical analysis. Patients with normal and abnormal glucose metabolism were compared in terms of age, ferritin, ALT, the number of total transfusion with Mann-Whitney U test. Results: The percentage of IDDM and IGT was determined as 6.06% and 12.12%, respective/y The mean age, number of total transfusion, maximum ferritin level and ALT levels of the patients with abnormal glucose metabolism was 12.8±3.9, 222±86 U, 4583±1116 mg/dl and 55±84U/L, respectively. ALT and maximum ferritin levels were found significantly high in thalassemic patients with abnormal glucose metabolism. HbsAg was found positive in all of the patients with one HBV DNA seropositivity. Condusiorı: Thalassemic patients should be followed up closely for abnormal glucose metabolism. It is recommended that glucose metabolism should be checked earlier in uncompliant patients and patients with HBV infection.