As noted recently by Jones et al., hypoglycemia is common in hospitalized patients with cystic fibrosis-related diabetes (CFRD) and is associated with an increase in readmission or death [1]. Though insulin therapy has been blamed for episodes of hypoglycemia, we noted ketonemia (elevated fingerstick 3-hydroxybutyrate) in several hospitalized patients with CFRD and hypoglycemia [2]; serum glucagon was low in one of these patients. Ketotic hypoglycemia is unlikely to be due to insulin therapy in this setting, and further study of this phenomenon is needed.
References
Jones GC, Chong ZM, Gilmour J, Matheson C, MacGregor G, Sainsbury CA. Patterns and impact of hypoglycemia, hyperglycemia, and glucose variability on inpatients with insulin-treated cystic fibrosis-related diabetes. Diabetes Ther. 2016;7:575–82.
Sanzone AM, Baird JS. 3-Beta hydroxybutyrate in cystic fibrosis and diabetic ketoacidosis: 46. Pediatr Crit Care Med. 2005;6:114.
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Baird, J.S. Letter to the Editor Regarding: Patterns and Impact of Hypoglycemia, Hyperglycemia, and Glucose Variability on Inpatients with Insulin-Treated Cystic Fibrosis-Related Diabetes. Diabetes Ther 7, 847 (2016). https://doi.org/10.1007/s13300-016-0202-y
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DOI: https://doi.org/10.1007/s13300-016-0202-y