IMPAIRED GLUCOSE TOLERANCE TEST IN BLOOD TRANSFUSION DEPENDENT BETA THALASSEMIC CHILDREN


Bablu Kumar Gaur, Sunita Koreti, G.Das

ABSTRACT
Impaired glucose tolerance and Serum ferritin level in transfusion-dependent β-thalassemic children was studied. Known case of beta Thalassemia major childrens being regularly transfused in Department of Pediatrics, Kamla Raja Hospital, Gwalior. 
This study was done on 60 children between 3-17 years of age with β thalassemia major. Information regarding name, age, sex, height, body weight, age at the first blood transfusion, frequency of blood transfusion per year, age at the start of iron-chelation therapy, compliance with chelation therapy, H/O Diabetes mellitus and history of previous splenectomy was taken. For each patient glucose tolerance test was performed and S.ferritin levels were  measured.
The prevalence of impaired glucose tolerance was 20%, the Serum ferritin was highly  raised in all  thalassaemic children, with highly statistical significant differences between normal and impaired GTT patients.(p.value<0.001) Mean serum ferritin was found to be 2089 ± 690 μg/l in patients with normal GTT while it was 4100 ± 518 μg/l in Impaired GTT. Significant variation was found (p value<0.05) in children with impaired glucose tolerance compared to normal glucose tolerance with respect to age, age of first blood transfusion, age of starting chelation therapy. Patients with impaired glucose tolerance had a mean transfusions of 137.58±20.15 times while those with normal glucose tolerance had 58.85±39.80 times of transfusions (p.value<0.001). 
Most of patients with impaired glucose tolerance in present study had received more then 100 blood transfusion and serum ferritin level >3000μg/L with mean age of 13.0 years indicating that abnormal glucose homeostasis begin after 10 year of age.

Keywords: beta-Thalassemia major, impaired glucose tolerance, Serum ferritin,chelation therapy.