hyoglycemiap

tammykrumrey · Jul 2, 2007

Here is the article I found. It really doesn't give much advice, but it does suggest that it can be an issue in CF patients.

Spontaneous hypoglycemia in patients with cystic fibrosis.Battezzati A, Battezzati PM, Costantini D, Seia M, Zazzeron L, Russo MC, Daccò V, Bertoli S, Crosignani A, Colombo C.
Department of Pediatrics, CF Center, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Italy. alberto.attezzati@unimi.it

OBJECTIVE: Diabetes frequently complicates cystic fibrosis (CF) without fasting hyperglycemia or despite spontaneous hypoglycemia (anecdotally ascribed to malnutrition), whose prevalence, clinical meaning, and relationship with glucose tolerance and clinical/nutritional status were not previously investigated. The relationship of CF genotype with insulin secretion control is also unclear. DESIGN AND METHODS: A total of 129 CF patients without stable diabetes received 188 oral glucose tolerance tests. Distribution of fasting plasma glucose (FPG), glucose, insulin and C-peptide responses, clinical/nutritional variables, and their relationships were analyzed. RESULTS: FPG < 60 mg/dl (3.3 mmo/l) was detected in 14% of studies and reactive hypoglycemia (PG < 50 mg/dl (2.8 mmo/l)) in 15%. OGTT-based diabetes frequency was similar in the lowest quartile (Q1) and Q2-3 for FPG (10 and 8%), with higher glucose increment and area under the curve in Q1. Insulin and C-peptide levels were similar among FPG quartiles. Class I cystic fibrosis transmembrane conductance regulator mutation carriers had higher insulin concentrations than class II, especially in Q1 for FPG. Age, sex, nutritional, and anthropometric parameters including fat and lean body mass were unrelated to FPG. Lower FPG was associated with more frequent hospitalization rates (P = 0.002) and lower Shwachman scores (P = 0.041). Steroids weaning was accurately evaluated but then excluded as a possible cause of hypoglycemia. CONCLUSIONS/INTERPRETATION: Fasting asymptomatic hypoglycemia is frequent and possibly related to inappropriate insulin secretion control in class I mutation carriers. Low FPG does not exclude impaired glucose tolerance (IGT) and diabetes in CF and reflects worse clinical status.

tammykrumrey · Jul 2, 2007

Here is the article I found. It really doesn't give much advice, but it does suggest that it can be an issue in CF patients.

Spontaneous hypoglycemia in patients with cystic fibrosis.Battezzati A, Battezzati PM, Costantini D, Seia M, Zazzeron L, Russo MC, Daccò V, Bertoli S, Crosignani A, Colombo C.
Department of Pediatrics, CF Center, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Italy. alberto.attezzati@unimi.it

OBJECTIVE: Diabetes frequently complicates cystic fibrosis (CF) without fasting hyperglycemia or despite spontaneous hypoglycemia (anecdotally ascribed to malnutrition), whose prevalence, clinical meaning, and relationship with glucose tolerance and clinical/nutritional status were not previously investigated. The relationship of CF genotype with insulin secretion control is also unclear. DESIGN AND METHODS: A total of 129 CF patients without stable diabetes received 188 oral glucose tolerance tests. Distribution of fasting plasma glucose (FPG), glucose, insulin and C-peptide responses, clinical/nutritional variables, and their relationships were analyzed. RESULTS: FPG < 60 mg/dl (3.3 mmo/l) was detected in 14% of studies and reactive hypoglycemia (PG < 50 mg/dl (2.8 mmo/l)) in 15%. OGTT-based diabetes frequency was similar in the lowest quartile (Q1) and Q2-3 for FPG (10 and 8%), with higher glucose increment and area under the curve in Q1. Insulin and C-peptide levels were similar among FPG quartiles. Class I cystic fibrosis transmembrane conductance regulator mutation carriers had higher insulin concentrations than class II, especially in Q1 for FPG. Age, sex, nutritional, and anthropometric parameters including fat and lean body mass were unrelated to FPG. Lower FPG was associated with more frequent hospitalization rates (P = 0.002) and lower Shwachman scores (P = 0.041). Steroids weaning was accurately evaluated but then excluded as a possible cause of hypoglycemia. CONCLUSIONS/INTERPRETATION: Fasting asymptomatic hypoglycemia is frequent and possibly related to inappropriate insulin secretion control in class I mutation carriers. Low FPG does not exclude impaired glucose tolerance (IGT) and diabetes in CF and reflects worse clinical status.

tammykrumrey · Jul 2, 2007

Here is the article I found. It really doesn't give much advice, but it does suggest that it can be an issue in CF patients.

Spontaneous hypoglycemia in patients with cystic fibrosis.Battezzati A, Battezzati PM, Costantini D, Seia M, Zazzeron L, Russo MC, Daccò V, Bertoli S, Crosignani A, Colombo C.
Department of Pediatrics, CF Center, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Italy. alberto.attezzati@unimi.it

OBJECTIVE: Diabetes frequently complicates cystic fibrosis (CF) without fasting hyperglycemia or despite spontaneous hypoglycemia (anecdotally ascribed to malnutrition), whose prevalence, clinical meaning, and relationship with glucose tolerance and clinical/nutritional status were not previously investigated. The relationship of CF genotype with insulin secretion control is also unclear. DESIGN AND METHODS: A total of 129 CF patients without stable diabetes received 188 oral glucose tolerance tests. Distribution of fasting plasma glucose (FPG), glucose, insulin and C-peptide responses, clinical/nutritional variables, and their relationships were analyzed. RESULTS: FPG < 60 mg/dl (3.3 mmo/l) was detected in 14% of studies and reactive hypoglycemia (PG < 50 mg/dl (2.8 mmo/l)) in 15%. OGTT-based diabetes frequency was similar in the lowest quartile (Q1) and Q2-3 for FPG (10 and 8%), with higher glucose increment and area under the curve in Q1. Insulin and C-peptide levels were similar among FPG quartiles. Class I cystic fibrosis transmembrane conductance regulator mutation carriers had higher insulin concentrations than class II, especially in Q1 for FPG. Age, sex, nutritional, and anthropometric parameters including fat and lean body mass were unrelated to FPG. Lower FPG was associated with more frequent hospitalization rates (P = 0.002) and lower Shwachman scores (P = 0.041). Steroids weaning was accurately evaluated but then excluded as a possible cause of hypoglycemia. CONCLUSIONS/INTERPRETATION: Fasting asymptomatic hypoglycemia is frequent and possibly related to inappropriate insulin secretion control in class I mutation carriers. Low FPG does not exclude impaired glucose tolerance (IGT) and diabetes in CF and reflects worse clinical status.

tammykrumrey · Jul 2, 2007

Here is the article I found. It really doesn't give much advice, but it does suggest that it can be an issue in CF patients.

Spontaneous hypoglycemia in patients with cystic fibrosis.Battezzati A, Battezzati PM, Costantini D, Seia M, Zazzeron L, Russo MC, Daccò V, Bertoli S, Crosignani A, Colombo C.
Department of Pediatrics, CF Center, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Italy. alberto.attezzati@unimi.it

OBJECTIVE: Diabetes frequently complicates cystic fibrosis (CF) without fasting hyperglycemia or despite spontaneous hypoglycemia (anecdotally ascribed to malnutrition), whose prevalence, clinical meaning, and relationship with glucose tolerance and clinical/nutritional status were not previously investigated. The relationship of CF genotype with insulin secretion control is also unclear. DESIGN AND METHODS: A total of 129 CF patients without stable diabetes received 188 oral glucose tolerance tests. Distribution of fasting plasma glucose (FPG), glucose, insulin and C-peptide responses, clinical/nutritional variables, and their relationships were analyzed. RESULTS: FPG < 60 mg/dl (3.3 mmo/l) was detected in 14% of studies and reactive hypoglycemia (PG < 50 mg/dl (2.8 mmo/l)) in 15%. OGTT-based diabetes frequency was similar in the lowest quartile (Q1) and Q2-3 for FPG (10 and 8%), with higher glucose increment and area under the curve in Q1. Insulin and C-peptide levels were similar among FPG quartiles. Class I cystic fibrosis transmembrane conductance regulator mutation carriers had higher insulin concentrations than class II, especially in Q1 for FPG. Age, sex, nutritional, and anthropometric parameters including fat and lean body mass were unrelated to FPG. Lower FPG was associated with more frequent hospitalization rates (P = 0.002) and lower Shwachman scores (P = 0.041). Steroids weaning was accurately evaluated but then excluded as a possible cause of hypoglycemia. CONCLUSIONS/INTERPRETATION: Fasting asymptomatic hypoglycemia is frequent and possibly related to inappropriate insulin secretion control in class I mutation carriers. Low FPG does not exclude impaired glucose tolerance (IGT) and diabetes in CF and reflects worse clinical status.

JustDucky · Jul 4, 2007

Years ago, I was diagnosed as reactive hypoglycemic which describes what your daughter did during her OGTT. I remember what it felt like, it was a Halloween and I had eaten alot of candy, no proteins, just candy that evening as I was busy at work and did not have time to eat a healthy dinner. Within a half an hour, I felt shaky, sweaty and became very pale. The nurse I was working with checked my sugar, actually she checked it three times because she or I could not believe the results....38! She wheeled me down to the ED where they gave me glucose, crackers and peanut butter with milk. Slowly they got my sugars up to 60 and I felt well enough to go home. After that, my doc made sure I ate at least 6 times a day with a balanced diet..(I had not been diagnosed with CF at that time, just asthma) According to my doc, what had happened is that when I loaded my body with all of those sugars, a ton of insulin was released into my body by my pancreas therefore dropping my sugars instead of raising them. That was over 10 years ago. Now I am on the flipside, I have diabetes now and take insulin, diagnosed a year ago. Go figure.
Anyhow, what does the doc say about this? (BTW tammykrumrey, good article)
Hugs to you, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

JustDucky · Jul 4, 2007

Years ago, I was diagnosed as reactive hypoglycemic which describes what your daughter did during her OGTT. I remember what it felt like, it was a Halloween and I had eaten alot of candy, no proteins, just candy that evening as I was busy at work and did not have time to eat a healthy dinner. Within a half an hour, I felt shaky, sweaty and became very pale. The nurse I was working with checked my sugar, actually she checked it three times because she or I could not believe the results....38! She wheeled me down to the ED where they gave me glucose, crackers and peanut butter with milk. Slowly they got my sugars up to 60 and I felt well enough to go home. After that, my doc made sure I ate at least 6 times a day with a balanced diet..(I had not been diagnosed with CF at that time, just asthma) According to my doc, what had happened is that when I loaded my body with all of those sugars, a ton of insulin was released into my body by my pancreas therefore dropping my sugars instead of raising them. That was over 10 years ago. Now I am on the flipside, I have diabetes now and take insulin, diagnosed a year ago. Go figure.
Anyhow, what does the doc say about this? (BTW tammykrumrey, good article)
Hugs to you, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

JustDucky · Jul 4, 2007

Years ago, I was diagnosed as reactive hypoglycemic which describes what your daughter did during her OGTT. I remember what it felt like, it was a Halloween and I had eaten alot of candy, no proteins, just candy that evening as I was busy at work and did not have time to eat a healthy dinner. Within a half an hour, I felt shaky, sweaty and became very pale. The nurse I was working with checked my sugar, actually she checked it three times because she or I could not believe the results....38! She wheeled me down to the ED where they gave me glucose, crackers and peanut butter with milk. Slowly they got my sugars up to 60 and I felt well enough to go home. After that, my doc made sure I ate at least 6 times a day with a balanced diet..(I had not been diagnosed with CF at that time, just asthma) According to my doc, what had happened is that when I loaded my body with all of those sugars, a ton of insulin was released into my body by my pancreas therefore dropping my sugars instead of raising them. That was over 10 years ago. Now I am on the flipside, I have diabetes now and take insulin, diagnosed a year ago. Go figure.
Anyhow, what does the doc say about this? (BTW tammykrumrey, good article)
Hugs to you, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

JustDucky · Jul 4, 2007

Years ago, I was diagnosed as reactive hypoglycemic which describes what your daughter did during her OGTT. I remember what it felt like, it was a Halloween and I had eaten alot of candy, no proteins, just candy that evening as I was busy at work and did not have time to eat a healthy dinner. Within a half an hour, I felt shaky, sweaty and became very pale. The nurse I was working with checked my sugar, actually she checked it three times because she or I could not believe the results....38! She wheeled me down to the ED where they gave me glucose, crackers and peanut butter with milk. Slowly they got my sugars up to 60 and I felt well enough to go home. After that, my doc made sure I ate at least 6 times a day with a balanced diet..(I had not been diagnosed with CF at that time, just asthma) According to my doc, what had happened is that when I loaded my body with all of those sugars, a ton of insulin was released into my body by my pancreas therefore dropping my sugars instead of raising them. That was over 10 years ago. Now I am on the flipside, I have diabetes now and take insulin, diagnosed a year ago. Go figure.
Anyhow, what does the doc say about this? (BTW tammykrumrey, good article)
Hugs to you, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

JustDucky · Jul 4, 2007

Years ago, I was diagnosed as reactive hypoglycemic which describes what your daughter did during her OGTT. I remember what it felt like, it was a Halloween and I had eaten alot of candy, no proteins, just candy that evening as I was busy at work and did not have time to eat a healthy dinner. Within a half an hour, I felt shaky, sweaty and became very pale. The nurse I was working with checked my sugar, actually she checked it three times because she or I could not believe the results....38! She wheeled me down to the ED where they gave me glucose, crackers and peanut butter with milk. Slowly they got my sugars up to 60 and I felt well enough to go home. After that, my doc made sure I ate at least 6 times a day with a balanced diet..(I had not been diagnosed with CF at that time, just asthma) According to my doc, what had happened is that when I loaded my body with all of those sugars, a ton of insulin was released into my body by my pancreas therefore dropping my sugars instead of raising them. That was over 10 years ago. Now I am on the flipside, I have diabetes now and take insulin, diagnosed a year ago. Go figure.
Anyhow, what does the doc say about this? (BTW tammykrumrey, good article)
Hugs to you, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

JustDucky · Jul 4, 2007

Years ago, I was diagnosed as reactive hypoglycemic which describes what your daughter did during her OGTT. I remember what it felt like, it was a Halloween and I had eaten alot of candy, no proteins, just candy that evening as I was busy at work and did not have time to eat a healthy dinner. Within a half an hour, I felt shaky, sweaty and became very pale. The nurse I was working with checked my sugar, actually she checked it three times because she or I could not believe the results....38! She wheeled me down to the ED where they gave me glucose, crackers and peanut butter with milk. Slowly they got my sugars up to 60 and I felt well enough to go home. After that, my doc made sure I ate at least 6 times a day with a balanced diet..(I had not been diagnosed with CF at that time, just asthma) According to my doc, what had happened is that when I loaded my body with all of those sugars, a ton of insulin was released into my body by my pancreas therefore dropping my sugars instead of raising them. That was over 10 years ago. Now I am on the flipside, I have diabetes now and take insulin, diagnosed a year ago. Go figure.
Anyhow, what does the doc say about this? (BTW tammykrumrey, good article)
Hugs to you, Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

NoExcuses · Jul 4, 2007