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Abstract
ABSTRACT
We report the results of glycemic indexes and several oral glucose tolerance test with pure glucose (OGTTGlc) vs. sucrose (OGTTSucr). In October 2021, all of the patient's blood glucose levels were normal. During OGTTGlc: T1HGlc < T0Glc or during OGTTSucr: T1HSucr > T0Sucr. In January 2022, blood glucose levels were still normal, Insulin resistance was occurring (HOMA-IRoct = 2.20 vs HOMA-IRjan = 3.68) and Insulin sensitivity was gradually collapsed. This allowed us to diagnose a 'mild' early reactive hypoglycemia. OGTT remains the best means for a clinical exploration of glucose metabolism disorders.
RÉSUMÉ
Nous rapportons les résultats d’indices glycémiques et de plusieurs hyperglycémies provoquées par voie orale au glucose pur (HGPOglc) et saccharose (HGPOSacc). En octobre 2021, toutes les glycémies de la patiente étaient normales. Pendant l’HGPOglc : T1HGlc < T0Glc or durant l’HGPOSacc : T1HSacc > T0Sacc. En janvier 2022, les glycémies étaient toujours normales, l’insulinorésistance apparaissait (HOMA-IRoct = 2,20 vs HOMA-IRjan = 3,68) et l’insulinosensibilité s’effondrait progressivement. Ceci nous a permis de poser le diagnostic d’hypoglycémie réactionnelle précoce ‘fruste’. L’HGPO demeure l’examen de choix pour l’exploration clinique des troubles du métabolisme du glucose.
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References
- Dufey, A., Ballan, B., K., Philippe, J. Hypoglycémie non diabétique : diagnostic et prise en charge. Rev Med Suisse 2013; 1(389): 1186 – 1191.
- Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009; 94(3): 709-728. doi:10.1210/jc.2008-1410.
- Sørensen M, Johansen O.E. Idiopathic reactive hypoglycaemia – Prevalence and effect of fibre on glucose excursions. Scand J Clin & Lab Invest, 2010; 70: 385–391.
- Sheen AJ, Luyckx FH. L’hyperglycémie provoquée par voie orale (HGPO) revisitée. 1ère partie : Tolérance au glucose, Diabète gestationnel et Hypoglycémie réactive. Med Mal Met 2010. 4(5): 569-574.
- Pourmotabbed G, Kitabchi AE. Hypoglycemia. ObstetGynecolClin North Am. 2001; 28(2): 383-400. Doi: 10.1016/s0889-8545(05)70207-2.
- Lefebvre PJ, Scheen AJ. The use of acarbose in the prevention and treatment of hypoglycaemia. Eur J Clin Invest. 1994 Aug; 24 Suppl 3:40-4. Doi: 10.1111/j.1365-2362.1994.tb02255.x. PMID: 8001627.
- Marks V, Teale JD. Hypoglycaemia in the adult. Baillieres Clin Endocrinol Metab. 1993; 7(3):705-729. Doi: 10.1016/s0950-351x(05)80215-0.
- Ahmadpour S, Kabadi UM. Pancreatic alpha-cell function in idiopathic reactive hypoglycemia. Metabolism 1997; 46: 639 – 43.
- Altuntaş Y. Postprandial Reactive Hypoglycemia. Sisli Etfal Hastan Tip Bul. 2019 Aug 28; 53(3):215-220. Doi: 10.14744/SEMB.2019.59455. PMID: 32377086; PMCID: PMC7192270.
- Brun JF, Fedou C, Mercier J. Postprandial reactive hypoglycemia. Diabetes Metab 2000; 26:337 – 51.
- Altuntas Y, Bilir M, Ucak S, Gundogdu S. Reactive hypoglycemia in lean young women with PCOS and correlations with insulin sensitivity and with beta cell function. Eur J Obstet Gynecol Reprod Biol. 2005; 119 (2):198-205. doi:10.1016/j.ejogrb.2004.07.038
- Scheen A.J. L’insulinorésistance : comment l’évaluer en pratique clinique? Mét Horm Diab & Nutr 2004. 8(1): 21-26.
- Utzschneider KM, Prigeon RL, Faulenbach MV, et al. Oral disposition index predicts the development of future diabetes above and beyond fasting and 2-h glucose levels [published correction appears in Diabetes Care. 2009 Jul; 32(7): 1355]. Diabetes Care. 2009; 32(2):335-341. Doi: 10.2337/dc08-1478.
- Gerstein HC, Santaguida P, Raina P, Morrison KM, Balion C, Hunt D, Yazdi H, Booker L. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res ClinPract. 2007 Dec; 78(3): 305-12. Doi: 10.1016/j.diabres.2007.05.004. PMID: 17601626.
References
Dufey, A., Ballan, B., K., Philippe, J. Hypoglycémie non diabétique : diagnostic et prise en charge. Rev Med Suisse 2013; 1(389): 1186 – 1191.
Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009; 94(3): 709-728. doi:10.1210/jc.2008-1410.
Sørensen M, Johansen O.E. Idiopathic reactive hypoglycaemia – Prevalence and effect of fibre on glucose excursions. Scand J Clin & Lab Invest, 2010; 70: 385–391.
Sheen AJ, Luyckx FH. L’hyperglycémie provoquée par voie orale (HGPO) revisitée. 1ère partie : Tolérance au glucose, Diabète gestationnel et Hypoglycémie réactive. Med Mal Met 2010. 4(5): 569-574.
Pourmotabbed G, Kitabchi AE. Hypoglycemia. ObstetGynecolClin North Am. 2001; 28(2): 383-400. Doi: 10.1016/s0889-8545(05)70207-2.
Lefebvre PJ, Scheen AJ. The use of acarbose in the prevention and treatment of hypoglycaemia. Eur J Clin Invest. 1994 Aug; 24 Suppl 3:40-4. Doi: 10.1111/j.1365-2362.1994.tb02255.x. PMID: 8001627.
Marks V, Teale JD. Hypoglycaemia in the adult. Baillieres Clin Endocrinol Metab. 1993; 7(3):705-729. Doi: 10.1016/s0950-351x(05)80215-0.
Ahmadpour S, Kabadi UM. Pancreatic alpha-cell function in idiopathic reactive hypoglycemia. Metabolism 1997; 46: 639 – 43.
Altuntaş Y. Postprandial Reactive Hypoglycemia. Sisli Etfal Hastan Tip Bul. 2019 Aug 28; 53(3):215-220. Doi: 10.14744/SEMB.2019.59455. PMID: 32377086; PMCID: PMC7192270.
Brun JF, Fedou C, Mercier J. Postprandial reactive hypoglycemia. Diabetes Metab 2000; 26:337 – 51.
Altuntas Y, Bilir M, Ucak S, Gundogdu S. Reactive hypoglycemia in lean young women with PCOS and correlations with insulin sensitivity and with beta cell function. Eur J Obstet Gynecol Reprod Biol. 2005; 119 (2):198-205. doi:10.1016/j.ejogrb.2004.07.038
Scheen A.J. L’insulinorésistance : comment l’évaluer en pratique clinique? Mét Horm Diab & Nutr 2004. 8(1): 21-26.
Utzschneider KM, Prigeon RL, Faulenbach MV, et al. Oral disposition index predicts the development of future diabetes above and beyond fasting and 2-h glucose levels [published correction appears in Diabetes Care. 2009 Jul; 32(7): 1355]. Diabetes Care. 2009; 32(2):335-341. Doi: 10.2337/dc08-1478.
Gerstein HC, Santaguida P, Raina P, Morrison KM, Balion C, Hunt D, Yazdi H, Booker L. Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes Res ClinPract. 2007 Dec; 78(3): 305-12. Doi: 10.1016/j.diabres.2007.05.004. PMID: 17601626.