Quisisana Hospital, Ferrara.
Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children's Hospital, Alexandria, Egypt.
Acta Biomed. 2022 May 11;93(2):e2022162. doi: 10.23750/abm.v93i2.12056.
The management of prediabetes and hyperglycemia is an increasingly important aspect of care in patients with thalassemia. In light of the limited evidence about the management of GD (glucose dysregulation) with glucose-lowering agents (GLAs), we have conducted a retrospective survey in TDT and NTDT patients with diabetes mellitus to collect more detailed information on GLA use in order to make preliminary recommendations.
A questionnaire was prepared and distributed to the tertiary thalassemia care Centers of ICET-A Network.
Eight thalassemia care Centers [Bulgaria, Greece, Iran, Italy (4 Centers) and Qatar], following 1.554 with transfusion-dependent thalassemia (TDT), 132 (8.4%) with diabetes and 687 with non-transfusion-dependent thalassemia (NTDT), 27 (3.9%) with diabetes, participated in the retrospective survey. The records of 117 TDT patients and 9 NTDT patients with diabetes treated with GLAs were analyzed. Metformin, a biguanide, was the most frequently used drug (47.6 %), followed by alpha-glucosidase inhibitors (5.5 %), incretins (4.7%) and insulin secretagogues (3.1%). In 68 (61.2) patients GLAs was prescribed as monotherapy, while the remaining 49 (38.8%), who had inadequate glucose control with metformin, were treated with combination treatment. Fifty-one patients of 126 (40.4%) initially treated with oral GLA, for a mean duration of 61.0 ± 35.6 months (range: 12- 120 months), required insulin therapy for better metabolic control.
This retrospective study covers an unexplored area of research in patients with thalassemia and GD. Oral GLAs appear to be safe and effective for the treatment of diabetes mellitus in patients with thalassemia, and can achieve adequate glycemic control for a substantial period of time.
糖尿病是地中海贫血患者治疗中日益重要的环节，而对血糖调节障碍（GD）的管理，尤其是使用降血糖药物（GLAs）的管理，目前相关证据有限。因此，我们对糖尿病地中海贫血患者进行了回顾性调查，以收集更详细的 GLAs 使用信息，从而提出初步建议。
我们准备了一份问卷，并分发给 ICET-A 网络的三家地中海贫血治疗中心。
共有 8 家地中海贫血治疗中心（保加利亚、希腊、伊朗、意大利（4 家中心）和卡塔尔）参与了此次回顾性调查，共纳入 1554 例输血依赖型地中海贫血（TDT）患者、132 例（8.4%）糖尿病患者和 687 例非输血依赖型地中海贫血（NTDT）患者、27 例（3.9%）糖尿病患者。共分析了 117 例 TDT 患者和 9 例 NTDT 患者使用 GLAs 的记录。二甲双胍作为双胍类药物是最常用的药物（47.6%），其次是α-葡萄糖苷酶抑制剂（5.5%）、肠促胰岛素（4.7%）和胰岛素分泌剂（3.1%）。68 例（61.2%）患者接受 GLAs 单药治疗，其余 49 例（38.8%）患者因二甲双胍血糖控制不理想而接受联合治疗。126 例患者中，51 例（40.4%）最初接受口服 GLAs 治疗，平均持续时间为 61.0±35.6 个月（范围：12-120 个月），为了更好地控制代谢，需要胰岛素治疗。
这项回顾性研究涵盖了地中海贫血和 GD 患者研究中一个未被探索的领域。口服 GLAs 似乎安全且有效，可用于治疗地中海贫血患者的糖尿病，并能在相当长的一段时间内实现血糖的充分控制。
