PREVALENCE OF DIABETES MELLITUS IN TRANSFUSION DEPENDENT BETA THALASSEMIA PATIENTS
Published on: Mar 4, 2016
Transcripts - PREVALENCE OF DIABETES MELLITUS IN TRANSFUSION DEPENDENT BETA THALASSEMIA PATIENTS
PREVALENCE OF DIABETES MELLITUS IN TRANSFUSION DEPENDENT BETA THALASSEMIA PATIENTS, CASE STUDY IN REGIONAL TRANSFUSION CENTER IN DAKHLIA, EGYPTDr. Faten Moftah DG of NBTSDr. Walaa Samra, Issuing Department, MRBTC.Dr. Nadia Eita DG of MRBTCDr.Rasha khalifa, Quality department, MRBTCBackground: Beta thalassemia is a serious disease generally diagnosed in first year oflife. The cause is genetic mutation that reduces the synthesis of beta globinchains of hemoglobin. Blood transfusion and iron chelating therapy haveimproved the quality of life of patients with thalassemia. In Egypt, Betathalassemia major represents a major health problem (prevalence rate of carriersis around 13%). Repeated blood transfusions in thalassemia lead to iron overload causingdiabetes. The early use of iron chelating agent leads to reduce body iron andhelps in preventing of diabetes. Impaired glucose tolerance is commonly seen inmultiply transfused beta thalassemia patients who could be attributed toprogressive loss of beta cell mass of pancreas.Aim of work: To evaluate the abnormalities in blood glucose homeostasis amongtransfusion dependent beta thalassemia major patients on iron chelating therapy.Methods: This study was carried out on randomly selected blood transfusiondependent thalassemic patients who are attending the Regional BloodTransfusion Center in Mansoura, Dakahlia, Egypt, from 1st February 2010 to30th June 2010. Patients with following features will be excluded from the study:
cases suffering from liver cirrhosis, cases suffering from renal failure and caseson drugs affecting blood glucose level. The study includes a total number of 100 subjects (90 thalassemic patients,10 healthy subjects).All patients and control subjects were submitted to fullclinical assessment including history taking, clinical examination and followinginvestigations: (1) complete blood count, (2) fasting (FBG) and two hours postprandial blood glucose levels (PPBG) and (3) estimation of serum insulin, ferittinand iron levels.Results: Thalassemic patients were classified into: 30 patients with normal bloodglucose level (group I) and 60 patients with diabetic blood glucose level (groupII).The prevalence of glucose homeostasis in thalassemic patients is 33.3 %normal blood glucose level and 66.7 % diabetic blood glucose level. Duration ofthalassemia plays an important role in the occurrence of diabetes in thalassemiamajor patients where it has negative significant correlation with serum insulinlevel in hyperglycemic group (P<-0.05). In group (I), serum ferritin and serum iron were not significantly correlatedto FBG, PPBG, serum insulin (P>0.05).In group (II), serum ferritin had positivesignificant correlation with FBG. Also, it had a highly significant correlation(P<0.001) with PPBG. However, serum ferritin had negative significantcorrelation with serum insulin. In group (II) serum iron was highly significantcorrelated to FBG, PPBG. However, serum iron had negative significantcorrelation with serum insulin.Summary / Conclusion: Our results suggest that iron overload state may cause insulin secretiondeficiency due to excessive deposition of iron in beta pancreatic cells. Werecommend that patients with beta thalassemia major especially with particular
risk factors like increase amount of blood transfusions should be screened fortype II diabetes.