Incidence of impaired glucose tolerance and diabetes mellitus in transfusion dependent thalassemia patients of rural Bengal - An institutional study

Abstract

: Thalassemia is the world’s commonest monogenic disorder. Molecular biology and genetics have revealed more than 200 mutations of thalassemia syndrome. These children become symptomatic from progressive haemolytic anaemia. They have to take lifelong treatments with regular packed red blood cell transfusion. Our body has no effective means of iron excretion and this leads to progressive iron accumulation in various organs after prolonged blood transfusion. This results in dysfunction of liver, heart and endocrine system and increased mortality. Iron toxicity to pancreatic beta cell leads to impairment in glucose metabolism. : Our study aims to find out the incidence of impaired glucose tolerance (IGT) and diabetes mellitus (DM) in transfusion dependent thalassemia major patients. This is an observational descriptive study carried out from January 2017 to June 2018. The study included 48 samples. There post-prandial blood sugar level and glycated haemoglobin (HbA1c) was analysed. Any proved case of juvenile diabetes mellitus was excluded from the study. We found that the incidence of IGT and DM were 12.5% and 4.16% respectively in our study population. The blood sugar level was significantly high in study group (p=<0.0001) as compared to the control group. The present study showed strong correlation between units of blood transfusion and blood sugar level as well as HbA1C percentage (in both cases p= <0.00001.)Thalassemia patients receiving regular blood transfusion are at increased risk of developing IGT and DM. Early initiation of chelation and judicious use of blood transfusion must be considered for these patients to prevent such complications.