Prevalence of diabetes mellitus in Chinese children with thalassaemia major

Objective Diabetes mellitus is a common endocrinopathy in patients with β ‐thalassaemia major ( β ‐ TM ), which is high prevalent in southern China. This study aimed to determine the cause and prevalence of glycaemic disorders in Chinese children with β ‐ TM . Methods In this prospective study, fasting glucose and insulin ( FINS ) levels were assessed in 267 β ‐ TM and 80 non‐ TM control children. Homeostatic model assessment ( HOMA ) and the quantitative insulin sensitivity check index ( QUICKI ) were evaluated. Iron overload was assessed by serum ferritin ( SF ), total units of blood transfused and cardiac T2*. Results β ‐TM had higher FPG ( P  < 0.001), FINS ( P  < 0.001) and HOMA ‐ IR ( P  < 0.05), but lower QUICKI ( P  < 0.01) than those of controls. The impaired fasting glucose ( IFG ) was present in 30% of children, whereas 2% had diabetes. The prevalence of IFG in β ‐ TM group was higher in children aged >10 years (OR 6.5; 95% CI 3.7–11.4; P  < 0.001), SF of >2500 μg/l ( OR 4.8; 95% CI 2.1–11.1; P  < 0.01), serum ALT levels of >50 IU/l ( OR 2.1; 95% CI 1.2–3.7; P  < 0.05) and cardiac T2* of <20 ms ( OR 3.3; 95% CI 1.7–6.6; P  < 0. 01). The children on deferiprone ( DFP ) had a reduced incidence of glycaemic aberrations than those on other chelating agents ( OR 0.4; 95% CI 0.23–0.8; P  < 0.05). Conclusions Our data suggest that IFG occurred in 30% of β TM children, perhaps due to insulin resistance secondary to iron overload. Deferiprone‐containing chelating agent may have a protective effect.