Session: MON 758-775-Beta Cells, Glucose Control & Complications
Poster Board MON-764
Methods: A retrospective chart review of 100 patients, who had unbiased glucose measurements by 72hr continuous glucose monitoring system (CGMS), identified 20 non-diabetic patients with AN who had symptoms suggestive of HYPO (postprandial dizziness, lightheadedness, nervousness, hunger relieved by food) [(17 with Neurogenic Orthostatic Hypotension: 2 post gastric bypass surgery)( 10 female: 10 male) (mean age= 54.8; range=22-76 yrs ) (Bezett QTc interval = 423-482mm; resting HR=77±4)]. Glucose values from CGMS were then mathematically transformed into % time above normal (%AN) (>140 mg%), % normal (%N) (70-140 mg%), and % below normal (%BN) (<70 mg%) for 3 time intervals: (T1=0600-1800hrs); (T2=1800-2400hrs); (T3=2400-0600hrs). Glucose averages for the 72 hr time period were also calculated.
Results: CGMS showed that 85% AN patients with symptoms had HYPO at least once during the 72 hrs of monitoring, more often at T1 (70%) than T2 (55%), T3(55%) and for all 3 time intervals combined. Glucose values %BN were 3.9 ±0.8, but %AN =16 ± 6.7 and %N =80 ± 6.9%. Patients with QTc < 440 mm had higher % BN for T1 (6.4±2.3 vs 2.5± 0.2; p<.05) and for overall %N (92.2 ± 1.6 vs 59.7 ±17.4; p<.001), but less overall % AN (3.2 ± 0.9 vs 37.0 ± 17.9; p<.001). Less AN, as measured by lower QTc interval, correlated with greater % of normal sugars (r2=-0.52; p<.05) and a lower resting HR (r2= 0.72; p=.002).
Conclusions: Patients with AN experience HYPO more often during the daytime with patterns suggestive of reactive hypoglycemia. Further, glucoregulation may depend upon the integrity of the autonomic nervous system, since patients with QTC<440 mm were more likely to be vulnerable to hypoglycemia. Therefore, it is important to evaluate all AN patients with nonspecific symptoms for hypoglycemia.
Nothing to Disclose: SP, MK, JLG, BGT, JS
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