ECE2017 Eposter Presentations: Diabetes, Obesity and Metabolism Diabetes (to include epidemiology, pathophysiology) (95 abstracts)
Endocrine factors associated with postprandial hypoglycaemia in patients with cystic fibrosis: a pilot study
Yasir Elamin 1 , Rachel Crowley 1, , ED Mckone 1 , Patrick Twomey 1, , Siobhan Hatton 1 , Julie Martin-Grace 1 & S Kearns 1
1St. Vincent’s University Hospital, Dublin, Ireland; 2University College Dublin School of Medicine, Dublin, Ireland.
Postprandial hypoglycaemia in patients with cystic fibrosis (PWCF) is frequently reported but poorly understood. The aim of this pilot study was to investigate the aetiology of postprandial hypoglycaemia in PWCF. Serum cortisol, insulin and C-Peptide were measured at the 2 hour timepoint of the annual glucose tolerance test in 32 PWCF not known to have CF-related diabetes. Hypoglycaemia was defined as glucose < 3.3 mmol/l. Patients were classified as Normal glucose tolerance (NGT; n=17), Post prandial hypoglycaemia (PPH; 6) and Abnormal glucose tolerance (AGT; 9–3 CF related diabetes, 4 impaired fasting glucose and 2 impaired glucose tolerance). There was a difference in insulin level at 2 hours between groups (P=0.007, Wilcoxon); subanalysis showed a difference between AGT (mean 48.9 mu/l) and PPH groups (16.6 mu/l)(P 0.003) and between AGT and NGT groups (28.4 mu/l) (P 0.015). Of the PPH cases none had symptomatic hypoglycaemia. Three PPH cases with cortisol < 500 nmol/l underwent short synacthen test (SST); 2 had a cortisol post-SST > 550 nmol/l. One patient showed suboptimal response with a cortisol level at 416 nmol/l and is undergoing further investigation. There were no differences between groups in body mass index (median 22.1 kg/m2) or lung function. PPH occurred in 19% of the cohort and was associated with detectable insulin at the 2 hour OGTT timepoint, suggesting the possibility of dysregulated insulin release. AGT patients had higher insulin levels than NGT cases, suggesting relative rather than absolute insulin deficiency in this cohort of PWCF.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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