The Pancreatic changes affecting glucose homeostasis in transfusion dependent β- thalassemia (TDT): a short review: Pancreatic changes and glucose homeostasis in β-thalassemia

The Pancreatic changes affecting glucose homeostasis in transfusion dependent β- thalassemia (TDT): a short review

Pancreatic changes and glucose homeostasis in β-thalassemia


  • Vincenzo De Sanctis Quisisana Hospital, Ferrara
  • Ashraf Soliman Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children’s Hospital, Alexandria, Egypt
  • Ploutarchos Tzoulis Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, N19 5NF UK
  • Shahina Daar Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
  • Bernadette Fiscina Department of Pediatrics, NYU School of Medicine, New York, NY, USA
  • Christos Kattamis First Department of Paediatrics, National Kapodistrian University of Athens 11527, Greece


Thalassemia; Iron overload; Viral hepatitis; Chronic liver disease; Insulin resistance; Diabetes mellitus


Background : The natural history of the glycometabolic state in transfusion-dependent β-thalassemia (TDT) patients is characterized by a deterioration of glucose tolerance over time. Aims:

This review depicts our current knowledges on the complex and multifacet pathophysiologic mechanisms implicated in the development of alteration of glucose homeostasis in patients with TDT. Search strategy: A systematic search was done on December 2020 including Web of Science (ISI), Scopus,  PubMed, Embase, and Scholar for papers published in the last 20 years. Moreover, we checked the reference lists of the relevant articles and previously performed reviews for additional pertinent studies. The personal experience on the care of patients with thalassemias is also reported. Conclusion: A regular packed red blood cells (PRBCs) transfusion program, optimization of chelation therapy, and prevention and treatment of liver infections are critical to achieve adequate glucometabolic control in TDT patients. Many exciting opportunities remain for further research and therapeutic development.


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The Pancreatic changes affecting glucose homeostasis in transfusion dependent β- thalassemia (TDT): a short review: Pancreatic changes and glucose homeostasis in β-thalassemia. Acta Biomed [Internet]. 2021 Jul. 1 [cited 2024 Jun. 21];92(3):e2021232. Available from:

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