Insulin-related metabolism following hematopoietic stem cell transplantation in childhood

Objectives: To assess insulin-related metabolism following hematopoietic stem cell transplantation (HSCT) in childhood. Study design: Thirty-four patients who underwent HSCT were compared with 21 patients with similar diseases who were not transplanted. Median follow-up was 3.6yr after HSCT. Anthropometric parameters, fasting plasma glucose and insulin levels, hemoglobin A_1c (HbA_1c ) and lipid profile were measured and compared. Results: HbA 1c was significantly higher (p = 0.001) in the study group. Two (5.8%) patients in the study group developed type 2 diabetes mellitus. Among thalassemic patients, significantly lower insulin resistance indices (p = 0.05) and fasting plasma insulin levels (p = 0.033) were found in the study group compared with the control group. Conclusions: Attentive follow-up of insulin-related metabolism following HSCT in children is needed. The significance of the higher HbA_1c values in the study group remains to be evaluated in a larger cohort of patients.