Natasha Armaghanian1, Tania P Markovic2, Jennie C Brand-Miller3, Peter T P Bye4, Carmel P Moriarty4, Kate S Steinbeck5. 1. Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Australia; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia. Electronic address: natasha.armaghanian@health.nsw.gov.au. 2. Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, Australia; Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, Australia. 3. Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, Australia; School of Molecular Bioscience, University of Sydney, Australia. 4. Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia. 5. Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Australia; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia; Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Australia.
Abstract
BACKGROUND: Hypoglycaemia in cystic fibrosis (CF) is known to occur during oral glucose tolerance tests (OGTT) and continuous glucose monitoring, however demographic, clinical and mechanistic data are limited. The aims of this study were to review patient electronic medical records (EMR) in order to 1) describe patient characteristics of a university teaching hospital CF clinic, 2) determine the prevalence of hypoglycaemia on OGTT and explore associations with demographic and clinical characteristics, and 3) explore patient reported symptoms suggestive of hypoglycaemia documented in the EMR. METHODS: Adults who attended the RPA CF clinic between January 2009 to April 2016 were included in the study. The prevalence of hypoglycaemia on OGTT was determined and clinical and demographic data were compared to age, sex and glucose tolerance matched controls. Reported symptoms suggestive of hypoglycaemia documented in EMR were qualitatively explored. RESULTS: Hypoglycaemia on OGTT was prevalent in 25 (3 fasting and 22 reactive) of 169 patients who had an OGTT. They were heavier, less likely to have pancreatic insufficiency and had a lower insulin response at 2-h. Another 14 patients reported symptoms suggestive of hypoglycaemia in their EMR. No patient appropriately suppressed insulin at 2-h on OGTT. CONCLUSIONS: This study identified two potentially different presentations of hypoglycaemia occur in different clinic sub-populations. Knowledge gaps in the aetiology and triggers of hypoglycaemia remain.
BACKGROUND:Hypoglycaemia in cystic fibrosis (CF) is known to occur during oral glucose tolerance tests (OGTT) and continuous glucose monitoring, however demographic, clinical and mechanistic data are limited. The aims of this study were to review patient electronic medical records (EMR) in order to 1) describe patient characteristics of a university teaching hospital CF clinic, 2) determine the prevalence of hypoglycaemia on OGTT and explore associations with demographic and clinical characteristics, and 3) explore patient reported symptoms suggestive of hypoglycaemia documented in the EMR. METHODS: Adults who attended the RPA CF clinic between January 2009 to April 2016 were included in the study. The prevalence of hypoglycaemia on OGTT was determined and clinical and demographic data were compared to age, sex and glucose tolerance matched controls. Reported symptoms suggestive of hypoglycaemia documented in EMR were qualitatively explored. RESULTS: Hypoglycaemia on OGTT was prevalent in 25 (3 fasting and 22 reactive) of 169 patients who had an OGTT. They were heavier, less likely to have pancreatic insufficiency and had a lower insulin response at 2-h. Another 14 patients reported symptoms suggestive of hypoglycaemia in their EMR. No patient appropriately suppressed insulin at 2-h on OGTT. CONCLUSIONS: This study identified two potentially different presentations of hypoglycaemia occur in different clinic sub-populations. Knowledge gaps in the aetiology and triggers of hypoglycaemia remain.
Authors: Marissa J Kilberg; Saba Sheikh; Darko Stefanovski; Christina Kubrak; Diva D De Leon; Denis Hadjiliadis; Ronald C Rubenstein; Michael R Rickels; Andrea Kelly Journal: J Cyst Fibros Date: 2019-08-08 Impact factor: 5.482
Authors: Moira L Aitken; Magdalena A Szkudlinska; Edward J Boyko; Debbie Ng; Kristina M Utzschneider; Steven E Kahn Journal: Diabetologia Date: 2020-01-29 Impact factor: 10.122