Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2016

Hypoglycaemia: Prevalence and characterisitics in non-diabetic adults with Cystic Fibrosis, attending a centre in Australia (#294)

Monica Wagenaar , Scott Bell 1 , Angela Matson 1 , Karen Herd 1 , Daniel Smith 1
  1. Cystic fibrosis Adult Centre, The Prince Charles Hospital, Chermside, Qld, Australia


CF patients with exocrine pancreatic insufficiency (PI) have less alpha, beta and pancreatic polypeptide cell function than sufficient patients.

Prevalence of non-diabetic hypoglycaemia (hypo) in adults with cystic fibrosis (CF), have been observed as 7-15%. No significant association between hypo and development of CF-related diabetes has been found to date.


Review prevalence and characteristics of hypoglycaemia, in non-diabetic adults with cystic fibrosis.


A retrospective audit was performed (2013) including pre transplant CF adults >18 years (n=275), excluding diabetic / impaired glucose tolerant patients (n=84). Audit group n=191.

Hypoglycaemic patients (plasma glucose < 3.9mmol/l), were compared with normal glucose tolerant (NGT) controls.

Additional characteristics were summarised.


Results indicate prevalence of non-diabetic hypoglycaemia: 28/275 patients (10.2 %). No differences were identified between hypo and NGT control groups for age, gender, genotype, liver disease and lung function.

Mean BMI was significantly less in hypo group (21.96 kg/m2 sd3.01) compared to controls (24.04 sd 4.63) (p=0.023). The hypo group had significantly higher pancreatic insufficiency (p<0.001).

Characteristics of the hypo group: mean onset 21.75years (sd7.09), mean length of diagnosis 5.46years (sd4.56), 89% symptomatic adrenergic reactions, 11% asymptomatic.

Most common hypo triggers: fasting/insufficient carbohydrates or delayed meal (61%).

The majority of prevention strategies received by patients was inclusion of regular low glycaemic index (GI) carbohydrates and higher protein items (75%).


This audit identified 10.2 % prevalence of non-diabetic hypoglycaemia.

The hypo group had significantly lower mean BMI and higher rate of pancreatic insufficiency. This may be due to lack of gluconeogenic reserves (lower BMI) and/or pancreatic dysfunction in hypoglycaemic pathophysiology. The majority of hypo patients reported symptomatic adrenergic reactions, the biggest trigger was fasting /insufficient carbohydrate or meal delay. The major prevention strategy in patient education was inclusion of regular low GI carbohydrate/high protein meals and snacks. Further studies are required.