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Spontaneous and iatrogenic hypoglycemia in cystic fibrosis
Spontaneous episodes of hypoglycemia can occur in people with cystic fibrosis (CF) without diabetes, who are not on glucose lowering medications. Spontaneous hypoglycemia in CF could occur both in the fasting or postprandial state (reactive hypoglycemia). The pathophysiology of fasting hypoglycemia...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551648/ https://www.ncbi.nlm.nih.gov/pubmed/34745906 http://dx.doi.org/10.1016/j.jcte.2021.100267 |
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author | Hicks, Rebecca Marks, Brynn E. Oxman, Rachael Moheet, Amir |
author_facet | Hicks, Rebecca Marks, Brynn E. Oxman, Rachael Moheet, Amir |
author_sort | Hicks, Rebecca |
collection | PubMed |
description | Spontaneous episodes of hypoglycemia can occur in people with cystic fibrosis (CF) without diabetes, who are not on glucose lowering medications. Spontaneous hypoglycemia in CF could occur both in the fasting or postprandial state (reactive hypoglycemia). The pathophysiology of fasting hypoglycemia is thought to be related to malnutrition and increased energy expenditure in the setting of inflammation and acute infections. Reactive hypoglycemia is thought to be due to impaired first phase insulin release in response to a glucose load, followed by a delayed and extended second phase insulin secretion; ineffective counterregulatory response to dropping glucose levels may also play a role. The overall prevalence of spontaneous hypoglycemia varies from 7 to 69% as examined with oral glucose tolerance test (OGTT) or with continuous glucose monitoring (CGM) under free living conditions. Spontaneous hypoglycemia in CF is associated with worse lung function, higher hospitalization rates, and worse clinical status. In addition, patients with CF related diabetes on glucose-lowering therapies are at risk for iatrogenic hypoglycemia. In this article, we will review the pathophysiology, prevalence, risk factors, clinical implications, and management of spontaneous and iatrogenic hypoglycemia in patients with CF. |
format | Online Article Text |
id | pubmed-8551648 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-85516482021-11-04 Spontaneous and iatrogenic hypoglycemia in cystic fibrosis Hicks, Rebecca Marks, Brynn E. Oxman, Rachael Moheet, Amir J Clin Transl Endocrinol Special Issue: CF Endocrinology Advance Spontaneous episodes of hypoglycemia can occur in people with cystic fibrosis (CF) without diabetes, who are not on glucose lowering medications. Spontaneous hypoglycemia in CF could occur both in the fasting or postprandial state (reactive hypoglycemia). The pathophysiology of fasting hypoglycemia is thought to be related to malnutrition and increased energy expenditure in the setting of inflammation and acute infections. Reactive hypoglycemia is thought to be due to impaired first phase insulin release in response to a glucose load, followed by a delayed and extended second phase insulin secretion; ineffective counterregulatory response to dropping glucose levels may also play a role. The overall prevalence of spontaneous hypoglycemia varies from 7 to 69% as examined with oral glucose tolerance test (OGTT) or with continuous glucose monitoring (CGM) under free living conditions. Spontaneous hypoglycemia in CF is associated with worse lung function, higher hospitalization rates, and worse clinical status. In addition, patients with CF related diabetes on glucose-lowering therapies are at risk for iatrogenic hypoglycemia. In this article, we will review the pathophysiology, prevalence, risk factors, clinical implications, and management of spontaneous and iatrogenic hypoglycemia in patients with CF. Elsevier 2021-10-13 /pmc/articles/PMC8551648/ /pubmed/34745906 http://dx.doi.org/10.1016/j.jcte.2021.100267 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Special Issue: CF Endocrinology Advance Hicks, Rebecca Marks, Brynn E. Oxman, Rachael Moheet, Amir Spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
title | Spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
title_full | Spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
title_fullStr | Spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
title_full_unstemmed | Spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
title_short | Spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
title_sort | spontaneous and iatrogenic hypoglycemia in cystic fibrosis |
topic | Special Issue: CF Endocrinology Advance |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551648/ https://www.ncbi.nlm.nih.gov/pubmed/34745906 http://dx.doi.org/10.1016/j.jcte.2021.100267 |
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