@article{3120094, title = "Clinical characteristics, biochemical parameters and insulin response to oral glucose tolerance test (OGTT) in 25 transfusion dependent β-thalassemia (TDT) patients recently diagnosed with diabetes mellitus (DM)", author = "de Sanctis, V. and Soliman, A. and Tzoulis, P. and Daar, S. and Karimi, M. and Yassin, M.A. and Pozzobon, G. and Kattamis, C.", journal = "Acta Biomedica", year = "2021", volume = "92", number = "6", publisher = "Mattioli 1885 Publishing Company", doi = "10.23750/abm.v92i6.12366", keywords = "alanine aminotransferase; deferasirox; deferiprone; deferoxamine; ferritin; glucose oxidase; hemoglobin A1c; hepatitis C antibody; insulin; levothyroxine; insulin, adolescent; adult; anthropometry; Article; beta cell function; beta thalassemia; body height; body mass; body weight; chelation therapy; clinical article; controlled study; diabetes mellitus; enzyme linked immunosorbent assay; fasting plasma glucose; female; glucometabolic status; glucose disturbance; homeostasis model assessment; human; hypogonadism; hypoparathyroidism; hypothalamic deficiency; impaired fasting glucose; impaired glucose tolerance; insulin concentration; insulin dependent diabetes mellitus; insulin release; insulin response; insulin secretory capacity; insulin sensitivity; insulinogenic index; International Network on Endocrine Complications in Thalassaemia; iron chelation; iron overload; lifestyle modification; liver dysfuction; liver iron content; male; matsuda index; middle aged; morphological trait; non insulin dependent diabetes mellitus; nuclear magnetic resonance imaging; obesity; oral disposition index; oral glucose tolerance test; pituitary deficiency; pubic hair; serology; splenectomy; T2 weighted imaging; transfusion dependent beta thalassemia; young adult; beta thalassemia; complication; diabetes mellitus; glucose blood level; glucose tolerance test; insulin resistance; non insulin dependent diabetes mellitus, beta-Thalassemia; Blood Glucose; Diabetes Mellitus; Diabetes Mellitus, Type 2; Female; Glucose Tolerance Test; Humans; Insulin; Insulin Resistance; Male", abstract = "Background: Patients with transfusion dependent β-thalassemia (TDT) are at high risk for developing, over the time, a form of diabetes distinct from type 1 and type 2 diabetes, but with similarities to both. Aims of study: The aim of this study is to describe the clinical and laboratory data, and the insulin secretion and sensitivity, in TDT patients recently diagnosed with diabetes mellitus (DM). Materials and Methods: The medical records of 25 TDT patients with DM, diagnosed by standardized oral glucose tolerance test (OGTT) and insulin secretion, were analysed; data were compared to TDT patients without diabetes and to a group of healthy subjects. Natural history of glucometabolic status before the diagnosis of DM was also reviewed. Results: On average, the TDT patients with DM were younger compared to TDT patients without diabetes. The mean age at diagnosis of DM in female and male TDT patients was 24.0 ± 7.1 years and 31.9 ± 5.6 years, respectively (P: 0.007). Serum alanine aminotransferase values, basal insulin levels and prevalence of hypogonadism were consistently higher in TDT patients with DM compared to those without diabetes. Decreased insulin secretion and increased insulin resistance was observed in patients with DM. Conclusion: The natural history of glucometabolic status in TDT patients is characterized by a deterioration of glucose tolerance over time. Iron overload and liver dysfuction are the main factors responsible for glucose disturbances (GD) in TDT patients. The therapeutic approach must be individualized and followed by a multidisciplinary team. (www.actabiomedica.it). © Mattioli 1885." }