Zanfardino Angela, Ozen Gulsum, Ippolito Giorgia, Roberti Domenico, Perrotta Silverio, Iafusco Dario, Del Giudice Emanuele Miraglia, Casale Maddalena
Regional Center for Pediatric Diabetes, Department of Pediatrics - University of the Study of Campania, via Sant'Andrea delle Dame, 4, Naples 80138, Italy.
Regional Center for Pediatric Diabetes, Department of Pediatrics - University of the Study of Campania, via Sant'Andrea delle Dame, 4, Naples 80138, Italy; Ankara Ataturk Sanatoryum Training and Research Hospital, Department of Pediatrics, Ankara, Turkey; Ankara University Faculty of Medicine, Department of Adolescent Health, Ankara, Turkey.
Diabetes Res Clin Pract. 2025 Apr;222:112076. doi: 10.1016/j.diabres.2025.112076. Epub 2025 Mar 1.
Continuous Glucose Monitoring (CGM) may help detect early dysglycemia in Transfusion-Dependent Thalassemia (TDT) patients, though previous reports suggest it may overestimate prediabetes prevalence. This study analyzed glucose-related metrics in TDT patients with negative diabetes screening tests, compared with healthy controls. A secondary objective was to assess the association between TAR140 > 6 % and clinical/laboratory characteristics of patients.
Patients resulted negative to the screening tests for glucose disorders were compared to healthy controls using CGM system for 7 days.
This study involved 39 participants (19 patients, 20 controls). HbA1c was falsely elevated in patients, despite normal mean glucose and GMI. Standard deviations and coefficients of variation were higher in patients than controls. No healthy control but 7/19 (37 %) TDT patients presented the interval TAR140 > 6 %. Significant differences were observed between "really euglycaemic" TDT patients (TAR140 ≤ 6 %) and "hyperglycemic" ones (TAR140 > 6 %) in terms of GMI, mean glucose and TAR140%. Comparing the glucose metrics of TDT euglycaemic patients (TAR140 ≤ 6 %) and healthy controls, no significant difference was reported. No differences in iron overload indexes were found between the hyperglycemia and euglycemia groups.
CGM reliably detects prediabetes in 37 % of TDT patients. TAR140 > 6 % may serve as a diagnostic cutoff.
连续血糖监测（CGM）可能有助于检测输血依赖型地中海贫血（TDT）患者的早期血糖异常，尽管先前的报告表明它可能高估了糖尿病前期的患病率。本研究分析了糖尿病筛查试验阴性的TDT患者的血糖相关指标，并与健康对照进行比较。第二个目的是评估TAR140>6%与患者临床/实验室特征之间的关联。
使用CGM系统对血糖紊乱筛查试验结果为阴性的患者与健康对照进行7天的比较。
本研究纳入39名参与者（19名患者，20名对照）。尽管平均血糖和糖化血红蛋白指数（GMI）正常，但患者的糖化血红蛋白（HbA1c）仍被错误地升高。患者的标准差和变异系数高于对照。没有健康对照出现TAR140>6%的区间，但7/19（37%）的TDT患者出现了该区间。在GMI、平均血糖和TAR140%方面，“真正血糖正常”的TDT患者（TAR140≤6%）和“高血糖”患者（TAR140>6%）之间观察到显著差异。比较TDT血糖正常患者（TAR140≤6%）和健康对照的血糖指标，未报告显著差异。高血糖组和血糖正常组之间的铁过载指标没有差异。
CGM能可靠地检测出37%的TDT患者的糖尿病前期。TAR140>6%可作为诊断临界值。
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