الفهرس 
IntroductionandRationaleOnly 14 pages are availabe for public view
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Abstract
Thalassemia is an autosomal recessive blood disorder and one of the most common hemoglobinopathies in the world. Lifelong frequent blood transfusions are recommended for transfusion-dependent thalassaemia. The human body doesn’t have a physiological mechanism for elimination of excess iron load following blood transfusion. Iron overload causes a variety of functional alterations in the human body. Excess iron accumulates particularly in the liver, heart, and endocrine organs. Diabetes mellitus is considered the third commonest endocrine complication. Although the exact mechanism of iron-induced diabetes is unknown, three major processes are believed to play a role in its development, insulin resistance, insulin insufficiency, and hepatic dysfunction. The goal of this study was to determine the frequency of glycemic abnormalities i.e. Diabetes Mellitusand insulin resistance in patients attending Hematology outpatient clinic of SuezCanalUniversityHospitals.Theobjectiveofthisstudywas toasses the relation between iron overload and glycemic abnormalities in thalassemic patients and To detect factors affecting glycemic abnormalities among thalassemia patients with early detection of glycemic abnormalities in patients with thalassemia to prevent its complications and start early and proper management. This study is an analytical cross-sectional study conducted over 67 patients attending the hematology outpatient clinic of Suez Canal University Hospital, Ismailia, Egypt, in the period between March 1 and June 10, 2022. Additionally, patients included were all thalassemic patients of either sexes aged more than 12 years old with exclusionoftype1DiabetesMellituspatientsandchronicliverdisease
patients.Patientswerewillingtoaccepttobeinterviewedthroughoutthe study. Collected data included the following:
• sociodemographicdata(age,sex,residency,educationallevel, economic state)
• Prediabeticanddiabeteshistoryincluding(symptoms,family history).
• Thalassemiahistory:(Ageofonsetoffirstbloodtransfusion, frequencyofbloodtransfusion,complianceonironchelating agents, splenectomy).
Our study demonstrated that 19.4% were diabetics and 35.8% were prediabetic among the thalassemia patients according to fasting glucose. On the other hand, regarding assessment of insulin resistance using homeostatic model assessment (HOMA-IR), 3 % of our study sample was within the border line range and 14.9% has HOMA IR more than 2. Significant correlation was found between frequency of blood transfusion and HbA1c (p=0.002), fasting insulin (p=0.008). However, considering the association between age of first transfusion and HOMA IR, results revealed significant association (p=0.049). Besides, there was positive correlation betweenserumferritinand HbA1c and HOMA IR with statisticallysignificant results of (p<0.001) and (p=0.041) respectively. Fasting insulin and serum iron showed statistically significant results of (p<0.001). Regarding studying the association between HOMA IR and fasting insulin, results was found to be statistically significant of (p<0.001). Also, by using binary logisticregressionmodelusingHOMA IR ≥2, fastingglucosewastheonlypredictor for insulin resistance (HOMA IR ≥ 2) with (p= 0.011).