Secondary Diabetes mellitus in Thalassemic Patients

Karagiorga-Lagana, Markissia; Chatziliami, Antonia; Katsantoni, A.; Karabatsos, Fotis; Fragodimitri, Christina; Tapaki, Georgia; Jousef, J.; Giannaki, Maria; Al-Qadreh, A.

doi:10.1007/978-88-470-2183-9_30

Cited by 4 publications

(7 citation statements)

References 8 publications

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“…In a recent study, Karagiorga-Lagana et al investigated 231 patients with thalassaemia aged 13 years and above, and reported that 9 patients (2.3%) had diabetes mellitus (16). In the study of De Sanctis et al, diabetes mellitus was observed in 29 (6.5%) of 448 patients with thalassaernia major (15).…”

Section: Incidencementioning

confidence: 99%

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Thyroid disorders and diabetes mellitus as complications of thalassaemia major

Pantelakis

1994

Acta Paediatrica

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Section: Incidencementioning

confidence: 99%

“…Diabetes mellitus is a well-documented complication of thalassaemia major, particularly among frequently transfused patients (1, [12][13][14][15][16].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Thyroid disorders and diabetes mellitus as complications of thalassaemia major

Pantelakis

1994

Acta Paediatrica

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“…The limitations of this study were unknown level of compliance of the use of iron-chelation and the lack of data regarding hepatitis B and C virus infection, which are the risk factors of diabetes mellitus in thalassemia. 5,11 The gold standard to evaluate the sensitivity of insulin is euglycemic insulin clamp, but it is a complicated procedure. In this study, oral glucose tolerance test (OGTT) was used and it is highly correlated with the euglycemic clamp.…”

Section: Discussionmentioning

confidence: 99%

“…1 In the absence of chelating therapy, the accumulation of iron results in progressive dysfunction of the heart, liver, and endocrine glands. [5][6][7] Impaired glucose tolerance (IGT) and diabetes mellitus (DM) may be the consequences of β-cell destruction secondary to iron overload, insulin resistance, hepatitis virus infection (mainly hepatitis C) and genetic factors. 1 Sanctis et al found that 5-15% of thalassemic patients suffered from IGT and DM.…”

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The prevalence of insulin resistance in patients with β -thalassemia major at Cipto Mangunkusumo Hospital

Mulawi¹,

Tridjaja²,

Abdulsalam³

et al. 2016

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Background Diabetes mellitus is a common complication in pa-tients with thalassemia major. Iron overload plays an important roleby damaging the pancreatic β-cell and the liver cell, with the con-sequences of insulin deficiency and insulin resistance. Family his-tory of diabetes mellitus is one of the critical factors for the devel-opment of glucose metabolism derangement. However, the patho-genesis of glucose metabolism derangement remains unclear.Objective To evaluate the prevalence of impaired glucose toler-ance, diabetes mellitus, and insulin resistance in patients with β-thalassemia major treated in the Thalassemia Outpatient Clinic,Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a descriptive cross sectional study conductedin May 2002. Forty-eight subjects aged 10 to 18 years, grouped bytotal volume of transfusions and family history of diabetes mellitus,underwent an oral glucose tolerance test (OGTT), serum transfer-rin saturation, and insulin level examinations. Insulin resistancewas calculated from fasting plasma glucose and insulin concen-trations using the homeostasis model assessment (HOMA).Results One of 48 patients (2%) had impaired glucose toleranceat the age of 17 years. Diabetes mellitus occurred in three of 48patients (6%) at the age of 15.5 years in one patient and 18 yearsin two patients. Family history of diabetes mellitus was found in 2patients with diabetes mellitus and in the only one with impairedglucose tolerance. Insulin resistance was not detected in this study.Conclusion The prevalence of glucose metabolism derangementin patients with thalassemia major was low. No insulin resistancewas found in this study

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Pregnancy outcomes and iron status in β-thalassemia major and intermedia: a systematic review and meta-analysis

Vlachodimitropoulou,

Mogharbel,

Kuo

et al. 2024

Blood Advances

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Advancements in orally bioavailable iron chelators and MRI methods have improved life expectancy and reproductive potential in Thalassemia Major (TM) and Thalassemia Intermedia(TI). Pregnancy is associated with adverse maternal and neonatal outcomes, frequency of which has not been well delineated. This systematic review aimed to provide risk estimates of maternal and fetal outcomes in TM and TI and explore pregnancy's impact on iron homeostasis. Fifteen studies (429 participants,684 pregnancies) were included. Meta-analysis revealed a higher thrombosis risk in TI (3.7%) compared to TM (0.92%), unchanged from pre-pregnancy. Heart failure risks in the earlier years appeared similar (TM 1.6% vs. TI 1.1%), and maternal mortality in TM was 3.7%, but with current management, these risks are rare. Gestational diabetes and pre-eclampsia occurred in 3.9% and 11.3% of TM pregnancies. Caesarean section rates were 83.9% in TM and 67% in TI. No significant difference in stillbirth, small for gestational age neonates, or preterm birth incidence between TM and TI was observed. n TM pregnancies, red cell requirements significantly increased (from 102 to 139 ml/kg/year,p=0.001), and 70% of TI pregnancies required blood transfusions. As expected, increased transfusion alongside chelation cessation led to a significant increase in serum ferritin during pregnancy (TM (by 1005 ng/mL,TI by 332 ng/mL,p<0.0001). Deterioration in iron status was further reflected by an increase in liver iron concentration(from 4.6 to 11.9mg/g dry weight, p<0.0001) and myocardial T2* decrease (from 36.2 +/-2.5ms to 31.1ms) during pregnancy. These findings emphasize the elevated maternal risk of iron-related cardiomyopathy during pregnancy and labor, stressing the importance of cardiac monitoring and postpartum chelation therapy resumption.

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Secondary Diabetes mellitus in Thalassemic Patients

Cited by 4 publications

References 8 publications

Thyroid disorders and diabetes mellitus as complications of thalassaemia major

Thyroid disorders and diabetes mellitus as complications of thalassaemia major

The prevalence of insulin resistance in patients with β -thalassemia major at Cipto Mangunkusumo Hospital

Pregnancy outcomes and iron status in β-thalassemia major and intermedia: a systematic review and meta-analysis

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