Diabetes Mellitus Associated With Cystic Fibrosis: Applying American Diabetes Association Standards

In Reply.— John Sheehan and Margaret Ulchaker make several interesting points in their letter. They were critical of the fact that nondiabetic patients were not proven to be so by glucose tolerance testing. To test more than 530 patients regularly with such testing is not felt to be indicated or practical in our clinic. Although such testing may identify individuals with abnormal glucose metabolism, this manuscript was concerned with survival of insulin-dependent diabetics.1 Such patients when untreated will spill sugar in their urine, and/or exhibit other clinical symptoms, and thus be identified at their regular clinic visits.

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Relationship between non-alcoholic fatty liver disease during pregnancy and abnormal glucose metabolism during and after pregnancy

Journal of Investigative Medicine ◽

10.1136/jim-2019-001186 ◽

2019 ◽

Vol 68 (3) ◽

pp. 743-747

Author(s):

Maryam Sattari ◽

Fernando Bril ◽

Robert Egerman ◽

Srilaxmi Kalavalapalli ◽

Kenneth Cusi

Keyword(s):

Diabetes Mellitus ◽

Liver Disease ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Post Partum ◽

Alcoholic Fatty Liver ◽

Abnormal Glucose Metabolism ◽

Alcoholic Fatty Liver Disease

While non-alcoholic fatty liver disease (NAFLD) is associated with increased risk of impaired glucose tolerance and type 2 diabetes mellitus (DM) in non-pregnant patients, the clinical significance of NAFLD during pregnancy is still unclear. We hypothesized that sonographic findings of NAFLD during pregnancy would be associated with gestational diabetes mellitus (GDM) and predict abnormal postpartum glucose metabolism. NAFLD was assessed by ultrasound during and after pregnancy. Standard 2-hour 75 g oral glucose tolerance test (OGTT) was used during pregnancy and post partum to establish GDM and the diagnosis of normal, impaired fasting glucose, or DM. We also measured plasma insulin, C peptide, and free fatty acids (FFA) concentration during an OGTT to evaluate glucose tolerance, insulin secretion and insulin resistance. Of the 84 subjects, 12 had sonographic evidence of NAFLD (5 of whom had OGTT post partum). There was a non-significant trend toward higher mean weight and body mass index during and after gestation in the NAFLD group, but no statistically significant differences in mean age, ethnicity, prepregnancy and postpregnancy hemoglobin A1C values, and postpartum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glucose, insulin, or FFA. We did not find an association between sonographic evidence of NAFLD during the third trimester of pregnancy and abnormal glucose metabolism during or after pregnancy. This study also suggests that while AST and ALT are not reliable diagnostic tools for NAFLD during the postpartum period, ultrasound is a reasonably safe, practical, and cost-effective modality to assess maternal hepatic fat during pregnancy.

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SAT-004 Prevalence of Abnormalities of Glucose Metabolism in Teenage Indian Girls with PCOS

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.172 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Vipan Talwar

Keyword(s):

Diabetes Mellitus ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Adolescent Girls ◽

Fasting Glucose ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Abnormal Glucose Metabolism

Abstract Background:Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders affecting young women and has been associated with an increased risk of impaired glucose tolerance and type 2 diabetes mellitus. However, there are very few studies on glucose abnormalities in Indian adolescent girls with PCOS. This study was conducted to determine the prevalence of abnormal glucose metabolism in this patient population. Method: Study group comprised of 106 young females aged 13–18 years. None of them were on metformin at the time of initial visit. Clinical examination along with Anthropometric evaluation was done and along with routine hormonal assessment they underwent a standard 75-g oral glucose tolerance test (OGTT). American Diabetes Association (ADA) criteria were used for diagnosis of diabetes (2 hr value>200mg/dl), Impaired glucose tolerance (2 hour value > 140 -199 mg/dl) and Impaired fasting glucose (blood glucose level of 100–125 mg/dl) Results:Out of 106 girls with PCOS diagnosis;1 girl met criteria for diagnosis of type 2 diabetes mellitus (0.9%).15 had impaired glucose tolerance (14.1%). In addition, 2 girls with impaired glucose tolerance were also noted to have impaired fasting glucose (1.9%).Abnormalities of glucose metabolism had significant correlation with BMI(p-0.02),Waist circumference (p-0.01) and testosterone levels (p-0.02). Conclusions:In our series of adolescent PCOS subjects, we report the prevalence of abnormal glucose metabolism to be 14.1% which is quite significant. Based on our results, we recommend that all adolescent girls with a diagnosis of PCOS should undergo formal oral glucose tolerance testing. Further studies are necessary in this field, so as to make guidelines regarding the timing and frequency of this testing, as well as its utility in the clinical management of these girls.

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Diabetes Mellitus Associated With Cystic Fibrosis: Applying American Diabetes Association Standards

PEDIATRICS ◽

10.1542/peds.87.5.748 ◽

1991 ◽

Vol 87 (5) ◽

pp. 748-748

Author(s):

JOHN P. SHEEHAN ◽

MARGARET M. ULCHAKER

Keyword(s):

Diabetes Mellitus ◽

Cystic Fibrosis ◽

Glucose Tolerance ◽

American Diabetes Association ◽

Glucose Tolerance Test ◽

Tolerance Test ◽

Diagnosis Of Diabetes Mellitus

To the Editor.— The article of Reisman et al1 in the September 1990 issue of Pediatrics suggests that a diagnosis of diabetes mellitus does not impact survival negatively, in contradiction to an earlier study.2 It is therefore pertinent to look at the diagnostic and treatment criteria for Reisman et al's patients. First, the nondiabetic patients were not proven to be so based on glucose tolerance test. A recent study highlighted the fact that the glucose tolerance test may be required to diagnose accurately more than 60% of patients.3

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Progression from impaired glucose tolerance to type 2 diabetes in obese children and adolescents: a 3–6-year cohort study in southern Thailand

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2016-0195 ◽

2016 ◽

Vol 0 (0) ◽

Cited By ~ 2

Author(s):

Somchit Jaruratanasirikul ◽

Sudarat Thammaratchuchai ◽

Maneerat Puwanant ◽

Ladda Mo-suwan ◽

Hutcha Sriplung

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Children And Adolescents ◽

Weight Status ◽

Obese Children ◽

Abnormal Glucose Metabolism

AbstractBackground:Childhood obesity is associated with abnormal glucose metabolism and type 2 diabetes mellitus (T2DM). This study evaluated the prevalence of abnormal glucose metabolism in asymptomatic obese children and adolescents, and determined the percentage of T2DM development after 3–6 years of follow-up.Methods:During 2007–2013, 177 obese children and adolescents who had normal fasting plasma glucose (FPG<100 mg/dL) were given an oral glucose tolerance test (OGTT). The participants were classified into four groups: normal glucose tolerance (NGT), NGT-hyperinsulinemia (NGT-HI), impaired glucose tolerance (IGT), and diabetes mellitus (DM). Blood chemistries, including FPG, glycated hemoglobin, and lipid profiles, and liver function test were performed every 6–12 months or when the patient developed any symptom or sign indicative of diabetes.Results:Glucose metabolism alterations were detected in 81.4% of the participants: 63.8% with NGT-HI, 15.3% with IGT, and 2.3% with T2DM. The median levels of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with IGT (8.63) were significantly greater than those in the patients with NGT (4.04) (p<0.01). During the follow-up, 22 patients (14.4%) developed T2DM significantly more from the IGT group (nine of 33 cases, 27.3%) than the NGT-HI group (12 of 108 cases, 11.1%) (p=0.022). The predicting parameters for T2DM conversion were weight status, body mass index (BMI), FBG, fasting insulin, alanine transaminase (ALT) levels, and HOMA-IR.Conclusions:Glucose metabolism alteration was commonly found among obese adolescents. Factors associated with T2DM development were greater weight status and the severity of insulin resistance as shown by higher HOMA-IR levels.

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Metabolic signatures in the conversion from gestational diabetes mellitus to postpartum abnormal glucose metabolism: a pilot study in Asian women

Scientific Reports ◽

10.1038/s41598-021-95903-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xi-Meng Wang ◽

Yan Gao ◽

Johan G. Eriksson ◽

Weiqing Chen ◽

Yap Seng Chong ◽

...

Keyword(s):

Diabetes Mellitus ◽

Glucose Metabolism ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Post Partum ◽

Diagnostic Biomarkers ◽

Serum Metabolites ◽

Abnormal Glucose Metabolism ◽

Metabolic Signatures

AbstractWe aimed to identify serum metabolites related to abnormal glucose metabolism (AGM) among women with gestational diabetes mellitus (GDM). The study recruited 50 women diagnosed with GDM during mid-late pregnancy and 50 non-GDM matchees in a Singapore birth cohort. At the 5-year post-partum follow-up, we applied an untargeted approach to investigate the profiles of serum metabolites among all participants. We first employed OPLS-DA and logistic regression to discriminate women with and without follow-up AGM, and then applied area under the curve (AUC) to assess the incremental indicative value of metabolic signatures on AGM. We identified 23 candidate metabolites that were associated with postpartum AGM among all participants. We then narrowed down to five metabolites [p-cresol sulfate, linoleic acid, glycocholic acid, lysoPC(16:1) and lysoPC(20:3)] specifically associating with both GDM and postpartum AGM. The combined metabolites in addition to traditional risks showed a higher indicative value in AUC (0.92–0.94 vs. 0.74 of traditional risks and 0.77 of baseline diagnostic biomarkers) and R2 (0.67–0.70 vs. 0.25 of traditional risks and 0.32 of baseline diagnostic biomarkers) in terms of AGM indication, compared with the traditional risks model and traditional risks and diagnostic biomarkers combined model. These metabolic signatures significantly increased the AUC value of AGM indication in addition to traditional risks, and might shed light on the pathophysiology underlying the transition from GDM to AGM.

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Impact of Glucose Metabolism Disorders on IGF-1 Levels in Patients with Acromegaly

Hormone and Metabolic Research ◽

10.1055/a-0594-2404 ◽

2018 ◽

Vol 50 (05) ◽

pp. 408-413 ◽

Cited By ~ 1

Author(s):

Sema Dogansen ◽

Gulsah Yalin ◽

Seher Tanrikulu ◽

Sema Yarman

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Normal Glucose Tolerance ◽

Glucose Metabolism Disorders ◽

Insulin Resistant ◽

Normal Glucose ◽

Resistant Group ◽

The Impact

AbstractIn this study, we aimed to evaluate the presence of glucose metabolism abnormalities and their impact on IGF-1 levels in patients with acromegaly. Ninety-three patients with acromegaly (n=93; 52 males/41 females) were included in this study. Patients were separated into three groups such as; normal glucose tolerance (n=23, 25%), prediabetes (n=38, 41%), and diabetes mellitus (n=32, 34%). Insulin resistance was calculated with homeostasis model assessment (HOMA). HOMA-IR > 2.5 or ≤2.5 were defined as insulin resistant or noninsulin resistant groups, respectively. Groups were compared in terms of factors that may be associated with glucose metabolism abnormalities. IGF-1% ULN (upper limit of normal)/GH ratios were used to evaluate the impact of glucose metabolism abnormalities on IGF-1 levels. Patients with diabetes mellitus were significantly older with an increased frequency of hypertension (p<0.001, p=0.01, respectively). IGF-1% ULN/GH ratio was significantly lower in prediabetes group than in normal glucose tolerance group (p=0.04). Similarly IGF-1% ULN/GH ratio was significantly lower in insulin resistant group than in noninsulin resistant group (p=0.04). Baseline and suppressed GH levels were significantly higher in insulin resistant group than in noninsulin resistant group (p=0.024, p<0.001, respectively). IGF-1% ULN/GH ratio is a useful marker indicating glucose metabolism disorders and IGF-1 levels might be inappropriately lower in acromegalic patients with insulin resistance or prediabetes. We suggest that IGF-1 levels should be re-evaluated after the improvement of insulin resistance or glycemic regulation for the successful management of patients with acromegaly.

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Diabetes Mellitus in Patients With Cystic Fibrosis: Effect on Survival

PEDIATRICS ◽

10.1542/peds.86.3.374 ◽

1990 ◽

Vol 86 (3) ◽

pp. 374-377

Author(s):

J. Reisman ◽

M. Corey ◽

G. Canny ◽

H. Levison

Keyword(s):

Diabetes Mellitus ◽

Cystic Fibrosis ◽

Survival Analysis ◽

Nutritional Status ◽

Pulmonary Function ◽

Survival Data ◽

Diabetes Diagnosis ◽

Patients With Diabetes ◽

Insulin Dependent ◽

Sick Children

Patient data obtained from the cystic fibrosis clinic of the Hospital for Sick Children (Toronto, Canada) over the period 1977 to 1988 were analyzed to compare the diabetic and nondiabetic cystic fibrosis patients. The pulmonary function, nutritional status, and survival data for 713 patients who attended the clinic over the 11-year period are reported. Insulin-dependent diabetes was found to exist in 37 (5.2%) of 713 patients. The patient age at time of diabetes diagnosis ranged from 2 to 34 years, with a mean ± SD of 20.0 ± 7.4 years. Patients who died in both the diabetic and nondiabetic groups had worse pulmonary and nutritional status than the surviving patients, but there were no significant differences between the diabetic and nondiabetic groups in those who died or in those who remained alive. Survival analysis showed a similar prognosis in the diabetic and nondiabetic groups. It is concluded that cystic fibrosis patients with diabetes are, for their age, not different from patients without diabetes with respect to pulmonary function, nutritional status, and survival.

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