Glucose tolerance, insulin secretion and peripheral sensitivity in thalassaemia major

Glyco-metabolic status was evaluated in 29 pubertal homozygous thalassaemic s aged from 17 to 42 years and in 12 age-matched healthy subjects. Diagnosi s of diabetes mellitus was assessed in 4 patients (13.8%), who became diabe tic after the age of 18 years. With respect to controls non-diabetic patien ts exhibited significantly higher fasting plasma glucose levels and more su stained glycemic responses to oral glucose tolerance test, whereas their ov erall insulin output was significantly lower. Moreover non-diabetic thalass aemic patients showed a clear reduction of both beta-cell function and insu lin resistance indices (HOMA model). In conclusion our data show a high pre valence of diabetes but do not support the existence of an insulin resistan t status in thalassaemia major, at least in adulthood.