Abstract
Forty oral glucose tolerance tests (GTTs) with concomitant insulin levels were performed in 19 children with thalassaemia major who needed blood transfusions to maintain a Hb level above 9% per 100 ml. Five children developed symptomatic diabetes requiring insulin and one had impaired tolerance. The glucose levels in GTTs were elevated and concomitant insulin levels were low. Before diabetes was diagnosed all the diabetic patients had received previous GTTs and in 4 of them insulin levels were raised at some point but glucose levels were normal. The diabetics had received between 130 and 435 units of blood and their liver iron concentrations varied between 1.8 and 5.1% of iron in dry liver weight. Other patients who were similarly iron loaded were asymptomatic, indicating a major difference between iron loading and iron toxicity. In 14 patients without diabetes, glucose levels were normal in GTTs but in 7 concomitant insulin levels were elevated at some stage. Raised insulin levels were found at the start of the GTT in 2 patients on 2 occasions, and at 2 hours in 5 patients. In another patient insulin levels were very high (300–400 units) in 2 tests but 4 years later were normal. The diabetic patients also had growth failure and delayed puberty and 2 had hypo-parathyroidism.
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Flynn, D., Fairney, A., Jackson, D. et al. GLUCOSE AND INSULIN METABOLISM IN THALASSAEMIC CHILIDREN. Pediatr Res 9, 668 (1975). https://doi.org/10.1203/00006450-197508000-00025
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DOI: https://doi.org/10.1203/00006450-197508000-00025