CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?

Background: Prediabetes and diabetes mellitus (DM) are complications in adult patients with transfusion dependent β-thalassemia (β-TDT), with their incidence increasing with age. Objective: This retrospective observational study describes the glycemic trajectories and evaluates predictive indices o...

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Main Authors: Vincenzo De Sanctis, Ashraf Soliman, Shahina Daar, Ploutarchos Tzoulis, Christos Kattamis
Format: Article
Language:English
Published: PAGEPress Publications 2024-01-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:https://mjhid.org/mjhid/article/view/5495
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author Vincenzo De Sanctis
Ashraf Soliman
Shahina Daar
Ploutarchos Tzoulis
Christos Kattamis
author_facet Vincenzo De Sanctis
Ashraf Soliman
Shahina Daar
Ploutarchos Tzoulis
Christos Kattamis
author_sort Vincenzo De Sanctis
collection DOAJ
description Background: Prediabetes and diabetes mellitus (DM) are complications in adult patients with transfusion dependent β-thalassemia (β-TDT), with their incidence increasing with age. Objective: This retrospective observational study describes the glycemic trajectories and evaluates predictive indices of β-cell function and insulin sensitivity/resistance in β-TDT patients with prediabetes, both in a steady state and during 3-h oral glucose tolerance test (OGTT), in order to identify patients at high risk for incipient diabetes. Setting: The study was mainly conducted at the Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara (Italy) in collaboration with thalassemia referring centers across Italy. Patients: The study included 11 β-TDT (aged 15.11- 31.10 years) with history of prediabetes. Methods: The ADA criteria for the diagnosis of glucose dysregulation were adopted. Investigations included evaluation of plasma glucose levels and insulin secretion, analysis of glycemic trajectories and indices of β-cell function and insulin sensitivity/resistance assessed in steady state and during OGTT. Results: The duration of progression from prediabetes to DM, expressed in years, showed a positive direct correlation with corrected insulin response (CIR-30 = r: 0.7606, P: 0.0065), insulinogenic index (IGI 0-120 = r: 0.6121, P:0.045), oral disposition index (oDI = r: 0.7119, P:0.013), insulin growth factor-1 (IGF-1= r: 0.6246, P: 0.039) and an inverse linear correlation with serum ferritin (SF = r: -0.7197, P: 0.012). Conclusions: Progressive β-cell failure, peripheral resistance to the action of insulin and reduction of oDI were the principal factors responsible for the progression from prediabetes to incipient DM.
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spelling doaj-art-31dbadb931f44007ac73d23c71b43faf2025-02-03T10:29:29ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062024-01-0116110.4084/MJHID.2024.005CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES? Vincenzo De Sanctis0Ashraf Soliman1Shahina Daar2Ploutarchos Tzoulis3Christos Kattamis4Accredited Private Hospital QuisisanaDepartment of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of OmanDepartment of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UKΤhalassemia Unit, First Department of Paediatrics, National Kapodistrian University of Athens 11527, Greece Background: Prediabetes and diabetes mellitus (DM) are complications in adult patients with transfusion dependent β-thalassemia (β-TDT), with their incidence increasing with age. Objective: This retrospective observational study describes the glycemic trajectories and evaluates predictive indices of β-cell function and insulin sensitivity/resistance in β-TDT patients with prediabetes, both in a steady state and during 3-h oral glucose tolerance test (OGTT), in order to identify patients at high risk for incipient diabetes. Setting: The study was mainly conducted at the Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara (Italy) in collaboration with thalassemia referring centers across Italy. Patients: The study included 11 β-TDT (aged 15.11- 31.10 years) with history of prediabetes. Methods: The ADA criteria for the diagnosis of glucose dysregulation were adopted. Investigations included evaluation of plasma glucose levels and insulin secretion, analysis of glycemic trajectories and indices of β-cell function and insulin sensitivity/resistance assessed in steady state and during OGTT. Results: The duration of progression from prediabetes to DM, expressed in years, showed a positive direct correlation with corrected insulin response (CIR-30 = r: 0.7606, P: 0.0065), insulinogenic index (IGI 0-120 = r: 0.6121, P:0.045), oral disposition index (oDI = r: 0.7119, P:0.013), insulin growth factor-1 (IGF-1= r: 0.6246, P: 0.039) and an inverse linear correlation with serum ferritin (SF = r: -0.7197, P: 0.012). Conclusions: Progressive β-cell failure, peripheral resistance to the action of insulin and reduction of oDI were the principal factors responsible for the progression from prediabetes to incipient DM. https://mjhid.org/mjhid/article/view/5495Transfusion dependent β-thalassemia, OGTT, pancreatic β-cell function, insulin sensitivity/resistance, risk factors, incipient diabetes.
spellingShingle Vincenzo De Sanctis
Ashraf Soliman
Shahina Daar
Ploutarchos Tzoulis
Christos Kattamis
CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?
Mediterranean Journal of Hematology and Infectious Diseases
Transfusion dependent β-thalassemia, OGTT, pancreatic β-cell function, insulin sensitivity/resistance, risk factors, incipient diabetes.
title CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?
title_full CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?
title_fullStr CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?
title_full_unstemmed CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?
title_short CAN WE PREDICT INCIPIENT DIABETES MELLITUS IN PATIENTS WITH TRANSFUSION DEPENDENT β-THALASSEMIA (β-TDT) REFERRED WITH A HISTORY OF PREDIABETES?
title_sort can we predict incipient diabetes mellitus in patients with transfusion dependent β thalassemia β tdt referred with a history of prediabetes
topic Transfusion dependent β-thalassemia, OGTT, pancreatic β-cell function, insulin sensitivity/resistance, risk factors, incipient diabetes.
url https://mjhid.org/mjhid/article/view/5495
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