Mongraw-Chaffin Morgana, Beavers Daniel P, McClain Donald A
Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States.
J Clin Transl Endocrinol. 2019 Jul 24;18:100202. doi: 10.1016/j.jcte.2019.100202. eCollection 2019 Dec.
Clinical visits of non-diabetic patients reporting hypoglycemic symptoms are common in endocrinology practices, but remain understudied and lack clinical definition and evidence-based recommendations for diagnosis or treatment. Our goal was to pilot test the concordance of hypoglycemic symptoms with low glucose values in young non-diabetic individuals.
We recruited eight individuals who reported regularly experiencing symptoms consistent with hypoglycemia to wear a blinded Dexcom continuous glucose monitor and report symptoms for seven days. We excluded individuals with diabetes or other known causes of hypoglycemia or similar symptoms.
Participants were all women with an average age of 29 years. 25% were African American and 25% had obesity. All participants experienced glucose values ≤ 70 mg/dL and half (4/8) experienced glucose ≤ 54 mg/dL for at least 15 min or 3 consecutive readings. Average time between last meal and reported symptoms was 4.4 h. Lower glucose values were significantly associated with higher odds of experiencing hypoglycemic symptoms 1.15 (CI: 1.07-1.24) for every -5mg/dL, (p < 0.001) from mixed effects models for repeated measures adjusted for age, race, and body mass index. All participants also reported engaging in potentially obesogenic behaviors in order to avoid symptoms.
Individuals with hypoglycemic symptoms in the absence of diabetes experience clinical hypoglycemia, indicating the need to understand the etiology, behavioral responses, and other health risks that might be associated with this understudied condition.
在内分泌科门诊中，非糖尿病患者报告有低血糖症状的临床就诊情况很常见，但仍未得到充分研究，缺乏针对诊断或治疗的临床定义和循证建议。我们的目标是对年轻非糖尿病个体低血糖症状与低血糖值的一致性进行初步测试。
我们招募了8名经常报告有与低血糖相符症状的个体，让他们佩戴盲法德康连续血糖监测仪，并报告7天内的症状。我们排除了患有糖尿病或其他已知低血糖原因或类似症状的个体。
参与者均为女性，平均年龄29岁。25%为非裔美国人，25%患有肥胖症。所有参与者的血糖值均≤70mg/dL，半数（4/8）参与者的血糖值≤54mg/dL至少持续15分钟或连续3次读数。最后一餐与报告症状之间的平均时间为4.4小时。根据针对年龄、种族和体重指数调整的重复测量混合效应模型，血糖值每降低-5mg/dL，出现低血糖症状的几率显著增加1.15（置信区间：1.07-1.24），（p<0.001）。所有参与者还报告为避免症状而采取了可能导致肥胖的行为。
无糖尿病的低血糖症状个体经历临床低血糖，这表明有必要了解这种研究不足的情况可能相关的病因、行为反应和其他健康风险。
