Evaluation of continuous glucose monitoring system for detection of alterations in glucose homeostasis in pediatric patients with β‐thalassemia major. Issue 1 (28th November 2018)

• Record Type: Journal Article
• Authors: El‐Samahy, Mona H.; Tantawy, Azza A.; Adly, Amira A.; Abdelmaksoud, Abeer A.; Ismail, Eman A.; Salah, Nouran Y.
• Is Part Of: Pediatric diabetes. Volume 20:Issue 1(2019)
• Page Start: 65
• Page End: 72
• Publication Date: 2018-11-28
• Subjects: continuous blood glucose monitoring system -- diabetes -- oral glucose tolerance test -- β‐thalassemia major; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12793
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract : Background: Disturbances of glucose metabolism are common in β‐thalassemia major (β‐TM). Aim: This study was conducted to assess the pattern of glucose homeostasis in pediatric β‐TM patients comparing oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS). Methods: Two‐hundred β‐TM patients were studied and those with random blood glucose (RBG) ≥7.8 mmol/L (140 mg/dL) were subjected to OGTT, insertion of CGMS and measurement of fasting C peptide, fasting insulin, and hemoglobin A1c (HbA1c). Results: Twenty patients (10%) had RBG ≥ 7.8 mmol/L. Using OGTT, 6 out of 20 patients (30%) had impaired glucose tolerance (IGT) while 7 (35%) patients were in the diabetic range. CGMS showed that 7/20 (35%) patients had IGT and 13 (65%) patients had diabetes mellitus (DM); 10 of the latter group had HbA1c readings within diabetic range. The percentage of diabetic patients diagnosed by CGMS was significantly higher than that with OGTT ( P = 0.012). Serum ferritin was the only independent variable related to elevated RBG. All β‐TM patients with DM were non‐compliant to chelation therapy. Conclusions: The use of CGMS in the diagnosis of early glycemic abnormalities among pediatric patients with β‐TM appears to be superior to other known diagnostic modalities.