The continuous glucose monitoring system (CGMS) in patients with beta-thalassemia major and impaired glucose homeostasis: preliminary results.

Impaired glucose tolerance (IGT) and diabetes mellitus (DM) are well known complications in ?-thalassemia major (TM). In recent years new technologies have become available for the management of these conditions, including the continuous glucose monitoring system (CGMS). We implanted CGMS in six TM patients with abnormal glucose homeostasis after an oral glucose tolerance test (OGTT). Two-hour OGTT glucose values and CGMS fluctuations were classified as normal if <7.8 mmol/l, impaired if 7.8 to 11.1 mmol/l, diabetic if >11.1 mmol/l. All participants completed the study. The length of recording ranged from 69:30 hours to 94:35 hours. The TM patients spent from 1 to 23% of the time with a blood glucose level from 7.8 to 11.1 mmol/l. In five patients the CGMS confirmed the impaired glucose tolerance diagnosis and in one patient the CGMS excluded the diagnosis of diabetes. Our results demonstrate that the CGMS is a useful method to detect the variability of glucose fluctuations and offers the opportunity for better assessment of glucose homeostasis in TM patients.