Results of OGTT...

Mistyjo

New member
Well, now I don't know what to think. Originally I thought she was having episodes of hypoglycemia and then we started testing at home and she never had any lows but she had some highs. The results today were all normal except the two hour one was a little low.
Fasting - 84,
30 minutes - 116,
One hour - 90,
Two hour - 61

Any thoughts? I will keep monitoring her levels at home. The reason we started monitoring was we had a terrible time waking her up a couple of weeks ago. We almost called squad.
I appreciate any advice!! Thanks!
 
M

Mommafirst

Guest
I really don't know much about this, but it sounds pretty normal to me. If the two hour post that yucky sugary stuff and with nothing else to eat, I could see the 61 being a drop off as she is needing food. Those numbers seem pretty "normal" to me. What did the doctor say?
 

Mistyjo

New member
They said it would take a couple of weeks for the doctor to get back to me. I'm going to assume its normal. I will continue to monitor at home just because she's had some a little high.
 

Incomudrox

New member
Those numbers are perfect. No reason to worry. Get a good diary and see a endo if you and the docs are still worried.
 

saveferris2009

New member
If your diary shows highs, then there are issues. As I recall, you have been keeping a diary the past week or so.

There is nothing magical about the OGTT - in fact, it's less accurate than keeping a 2 week diary. Highs are highs.

I passed my OGTT with flying colors 3 months in a row - yet I did diaries at home and I was getting 2 hours at 200+. A good OGTT doesn't make CFRD go away, unfortunately. It will still damage the lungs, kidneys, eyes, blood vessels, etc.
 

Mistyjo

New member
Saveferris, you're the reason I am going to continue to monitor her levels. She has had some highs. There has to be a reason for it.
Thanks everyone!!
 

Havoc

New member
I can't find any concrete information that says that increased blood serum translates to increased airway surface liquid glucose. In fact, just the opposite. There is a facilitated diffusion mechanism that clears glucose from ASL as fast or faster than it can be transferred from basal cells.

Furthermore, with a 2 hour level at 61mg/dl if you start treating for CFRD, she is gonna crash with a hypoglycemic event.
 

Mistyjo

New member
I'm going to keep track of her levels. I couldn't wake her up one morning and that alone is enough to keep checking it. She scared us!
 

saveferris2009

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Havoc</b></i> I can't find any concrete information that says that increased blood serum translates to increased airway surface liquid glucose. In fact, just the opposite. There is a facilitated diffusion mechanism that clears glucose from ASL as fast or faster than it can be transferred from basal cells.</end quote>

But glucose feeds the bacteria in our lungs. And all CFF studies show that untreated CFRD decreases lung function.
I agree with the 60 not needing to be treated - but she's had results in the 160s if I recall?
 

Mistyjo

New member
Yes, she had 164 two hrs after eating. Three hrs after eating it was 147.
Saveferris, what were your results?
 

Havoc

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>saveferris2009</b></i> <div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Havoc</b></i> I can't find any concrete information that says that increased blood serum translates to increased airway surface liquid glucose. In fact, just the opposite. There is a facilitated diffusion mechanism that clears glucose from ASL as fast or faster than it can be transferred from basal cells.</end quote> But glucose feeds the bacteria in our lungs. And all CFF studies show that untreated CFRD decreases lung function.</end quote>
I've never seen a study that suggests that increased blood serum glucose directly affects glucose levels in airway surface liquid. In fact, just the opposite, the body has a natural mechanism to keep glucose actively transported out of ASL. I'll have to do more digging. I'm out on business until at least tuesday.
 

JustDucky

New member
Here's an interesting article: " Hyperglycemia and cystic fibrosis alter respiratory fluid glucose levels" http://jap.physiology.org/content/102/5/1969.full.pdf

Very informative!
Jenn 40 wCF
 

JustDucky

New member
A snippet from the article posted above: "ucose concentrations.
CFRD. Breath glucose was higher in patients with CFRD
than in all other groups, including CF patients without diabetes.
CFRD patients also had a higher breath-to-blood glucose ratio
than CF patients without diabetes, indicating that elevated
breath glucose was due to additional respiratory epithelial
dysfunction and not to elevated blood glucose alone. Elevated
luminal glucose concentrations could simply be a marker for
worsening pulmonary disease or could have a causative role.
Glucose stimulates production of proin?ammatory cytokines
(12) and, at concentrations found in respiratory ?uid, stimulates growth of CF respiratory pathogens...."

Jenn 40 wCF
 

saveferris2009

New member
Havoc - it seems that there are clear studies that show CFRD and lower lung function are often found together:

"Decreased Lung Function in Female but not Male Subjects With Established Cystic Fibrosis - Related Diabetes" http://care.diabetesjournals.org/content/28/7/1581.short (who wants to bet this URL won't be hyperlinked?)

From the amazing Dr. Warwick " We conclude that the degree of glucose intolerance is a strong determinant of future lung function decline in patients with CF." http://ajrccm.atsjournals.org/content/162/3/891.short

<b><u>"Lung function and clinical status deteriorate up to 2 - 4 years before a diagnosis of CFRD based on the oral glucose tolerance test (OGTT)" </b></u> - exactly what happened to me. http://adc.bmj.com/content/87/5/430.short

":The presence of CFRD was associated with poorer lung function, poorer bone mineral density and an increased prevalence of PSEUDOMONAS AERUGINOSA in sputum. The R117H mutation may be protective for CFRD." http://cat.inist.fr/?aModele=afficheN&cpsidt=17698442


Are these the types of articles you were looking for, Havoc? I always enjoy your POV so let me know your thoughts <img src="i/expressions/face-icon-small-smile.gif" border="0">
 

Havoc

New member
<div class="FTQUOTE"><begin quote><em>Originally posted by: <strong>saveferris2009</strong></em> Are these the types of articles you were looking for, Havoc? I always enjoy your POV so let me know your thoughts <img alt="" /></end quote>

Yes. With the exception of the last study you cited, it seems that increased PFt's had to do more with increase in BMI, which we know has a linear correlation with lung function, and not necessarily bacterial conlonization. These articles are also older and I was unable to search for any refutations (I'm still out of town on business). The research I have found is recent and suggests that BSG does not have any impact on the amout of glucose in airway surface liquid, which is what you would need to support a hypothesis that increased BSG feeds colonies of bacteria in the lungs. Here is the link the the study (it's long)
<a href="http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0016166">http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0016166</a>
For those that may not want tpo read the whole thing, here is an excerpt:


<span>In this study, we describe a novel mechanism that allows human airway epithelia to generate a transepithelial glucose concentration gradient. Moreover, this gradient results in an ASL that contains a low glucose concentration. Our studies suggest that this low concentration of glucose plays an important role in limiting the growth of bacteria and maintaining the sterility on the surface of human airway epithelia and leads us to speculate that the concentration of other carbon sources in ASL may also be low.
Glucose is exclusively supplied to the airways from circulating blood, reaching the basolateral side of epithelial cells, where uptake of glucose can occur. Glucose can reach the ASL through both the paracellular and transcellular pathways at a specific rate, but the epithelial cells have the capacity to absorb it through the apical membrane at an equal or higher rate (<a href="http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0016166#pone-0016166-g003">Figure 3D</a>).
What is the driving force that allows epithelial absorption of glucose from both the apical and basolateral compartments? Our data supports interesting conclusions. Intracellular glucose, under normal conditions, is constantly phosphorylated by hexokinase in an ATP-dependent reaction, creating flux into a chemical “fourth compartment”. This would maintain an intracellular non-phosphorylated glucose concentration that is lower than that of blood, and a glucose concentration gradient that can be the driving force for basolateral uptake. Any glucose reaching the ASL would therefore be absorbed at a rate that would keep it at concentration equilibrium with intracellular non-phosphorylated glucose (<a href="http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0016166#pone-0016166-g006">Figure 6, A</a>). Data supporting this idea come from studies performed in isolated lung cells grown in suspension, in which the intracellular concentration of glucose was found to be[41].
 

Mistyjo

New member
Endo just called. She said all the results aren't back yet from the OGTT. She will know more once she gets the results in. She said to make sure she eats and doesn't skip meals while on vacation. If she is acting funny and blood sugar is below 60 to call squad. She said Jasey's weight is playing a role because she doesn't have good reserve to be able to skip meals.
I guess we will know more in a couple of weeks when we get back from vacation.
 
Top