Data di Pubblicazione:
2007
Citazione:
Spontaneous hypoglycemia in patients with cystic fibrosis / A. Battezzati, P.M. Battezzati, D. Costantini, M. Seia, L. Zazzeron, M.C. Russo, V. Daccò, S. Bertoli, A. Crosignani, C. Colombo. - In: EUROPEAN JOURNAL OF ENDOCRINOLOGY. - ISSN 0804-4643. - 156:3(2007 Mar), pp. 369-376. [10.1530/eje.1.02344]
Abstract:
BACKGROUND: Cystic fibrosis (CF)-related diabetes is a leading complication of CF and is associated with pulmonary and nutritional deterioration, years before an evident hyperglycemia, possibly because of insulin deficiency and resistance.
AIM: To evaluate glucose tolerance, insulin secretion, and insulin sensitivity by a widely applicable method suitable for accurate and prospective measurements in a CF population.
METHODS: A total of 165 CF subjects (80 females) aged 17±5 years and 18 age- and sex-matched healthy controls (CON) received an oral glucose tolerance test with glucose, insulin and C-peptide determinations. Insulin sensitivity was defined on the basis of glucose and insulin concentrations using the oral glucose insulin sensitivity index, whereas β-cell function was determined on the basis of a model relating insulin secretion (C-peptide profile) to glucose concentration.
RESULTS: Fifteen percent of CF patients had glucose intolerance and 6% had diabetes without fasting hyperglycemia and 3% had diabetes with fasting hyperglycemia. β-cell function was reduced in CF patients compared with CON (70.0±4.1 vs 117.9±11.6 pmol/min per m(2) per mM, P<0.001) and decreased significantly with age by -2.7 pmol/min per m(2) per mM per year (confidence interval (CI) -4.5 to -0.82), i.e. almost 4% yearly. The early insulin secretion index was also reduced. Insulin sensitivity was similar to CON. CF patients who attained glucose tolerance comparable to CON had lower β-cell function and higher insulin sensitivity.
CONCLUSION: The major alteration in insulin secretion and insulin sensitivity of CF patients is slowly declining β-cell function, consisting of delayed and reduced responsiveness to hyperglycemia, that in CF patients with normal glucose tolerance may be compensated by an increased insulin sensitivity.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
A. Battezzati, P.M. Battezzati, D. Costantini, M. Seia, L. Zazzeron, M.C. Russo, V. Daccò, S. Bertoli, A. Crosignani, C. Colombo
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