Long-term retrospective study on the progression of prediabetes to diabetes mellitus in transfusion-dependent β-thalassemia (β-TDT) patients: The experience in Oman and Italy: From prediabetes to diabetes mellitus in thalassemia

Long-term retrospective study on the progression of prediabetes to diabetes mellitus in transfusion-dependent β-thalassemia (β-TDT) patients: The experience in Oman and Italy

From prediabetes to diabetes mellitus in thalassemia


  • Vincenzo De Sanctis Quisisana Hospital, Ferrara https://orcid.org/0000-0002-6131-974X
  • Shahina Daar Department of Hematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman
  • Ashraf Soliman Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar
  • Saveria Campisi UOSD Thalassemia, Umberto I° Hospital, Siracusa, Italy
  • Ploutarchos Tzoulis Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UK


β-thalassemia major, prediabetes, diabetes,OGTT, HOMA2- IR, HOMA2-% β, HOMA2-%S.


Background: Prediabetes in transfusion-dependent β-thalassemia (β-TDT) patients is a significant risk factor for development of diabetes mellitus (DM), with increasing incidence with age. Objectives: This retrospective study aimed to compare the progression from prediabetes to DM in β-TDT patients who initiated iron chelation therapy (ICT) before age 6 and between ages 6 and 10. Additionally, we sought to characterize the trajectories of fasting and post-glucose load insulin sensitivity and secretion (HOMA2-%S and HOMA2-% β) in a β-TDT subgroup, monitored annually for four years preceding DM diagnosis. Research Design and Methods: We retrospectively reviewed annual oral glucose tolerance test (OGTT) data for 18 β-TDT patients from Oman and Italy, from the onset of prediabetes to DM diagnosis. Results: The mean age at prediabetes diagnosis was 17.5 ± 4.2 years, and at DM diagnosis was 21.6 ± 5.2 years. A direct correlation was observed between the age at prediabetes and DM diagnosis (r: 0.6925, P: 0.0014). Three years before DM diagnosis, a notable increase in baseline, 1-hour, and 2-hour post-load plasma glucose levels during OGTT was observed, alongside a decrease in HOMA2-% β. Conclusions: Elevated 1-hour post-load plasma glucose levels and a declining HOMA2-% β during the transition to DM are indicative markers for identifying β-TDT patients with high likelihood for imminent progression to DM.


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How to Cite

Long-term retrospective study on the progression of prediabetes to diabetes mellitus in transfusion-dependent β-thalassemia (β-TDT) patients: The experience in Oman and Italy: From prediabetes to diabetes mellitus in thalassemia . Acta Biomed [Internet]. 2024 Feb. 28 [cited 2024 May 20];95(1):e2024050. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/15525

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