Continuous Glucose Monitoring Abstracts from AACE - Part II

The AACE highlighted a number of studies on a wide range of endocrinology topics from adrenal disorders to metabolic bone disease. Listed below are just a few of the interesting items featured under the diabetes category, the following focus on continuous glucose monitoring studies:

Abstract #220Diabetes Control among Haitians versus African-Americans in an Urban Safety-net HospitalAuthors: Vimalananda V, Lasser K, Cabral H, Rosenzweig J

Purpose: Because “Haitians comprise 19% of the black population in Boston,” researchers undertook a “retrospective, crosssectional study of diabetes control, quality of care, and complication rates among Haitian and African-American patients at an urban safety-net hospital” in order to “describe the burden of diabetes in this ethnic subgroup.”

Results: “Despite a lower BMI and similar rates of lab testing, Haitians have poorer glycemic and BP control than do African-Americans.” In light of the fact that Hatians exhibit “a strikingly lower rate of several diabetic complications,” the authors hypothesize that this “may be due to under-diagnosis and underdocumentation or other factors.”

Abstract #289HbA1c as a Predictor of Glycemic Burden in African Americans and CaucasiansAuthors: Dagogo-Jack S, Edeoga C, Egbuonu N, Chapp-Jumbo E

Purpose: Despite “emerging data on ethnic disparities in the relationship between A1c and glycemic burden among subjects with diabetes or pre-diabetes…it is not known whether such disparities extend to healthy nondiabetic subjects or whether genetic risk for diabetes plays a role.” To that end, the authors undertook this research effort.

Results: After subjecting patients to “standard anthropometric measurements (weight, height, waist circumference)…a 75g Oral Glucose Tolerance Test (OGTT) after an overnight fast and…a second measurement of fasting plasma glucose (FPG) ~45 days from the date of OGTT,” researchers found that even “among healthy subjects at similar genetic risk for diabetes… African Americans had significantly higher A1c levels than Caucasians, despite similar FPG, 2hPG, insulin sensitivity and beta cell function.” These findings suggest, the authors say, that “A1c overestimates glycemic burden in black subjects, and may be inappropriate for diagnosis of diabetes in that population.”

Abstract #527Functional Hypoparathyroidism and Tetany in Celiac DiseaseAuthors: Gundu Rao N, Balestra R

Purpose: “To recognize the etiology of hypocalcemia and functional hypoparathyroidism in celiac disease.”

Results: The authors present the case of a “39-year-old African-American woman with a history of recently diagnosed celiac disease and pernicious anemia, presented with sudden onset of painful muscle spasms involving the hands, feet and face with symptoms of jaw locking.” Laboratory tests and physical examination revealed hypertension and a positive Troussea’s sign, and an inappropriately low intact parathyroid hormone level “for her calcium…The patient’s symptoms of tetany and hypertension resolved with intravenous repletion of calcium and magnesium. With the correction of hypomagnesemia, iPTH increased to 111 ng/dl. The corresponding calcium was 8.2 mg/dl. The patient was then started on oral magnesium, calcium and vitamin D supplements. Her low magnesium levels were likely related to her gastrointestinal losses secondary to underlying celiac disease.” These findings, the researchers note, highlight the “intricate interplay between calcium and magnesium metabolism,” and caution that “functional hypoparathyroidism can lead to lethal complications, unless promptly recognized and treated seen in this patient.”

Abstract #700Renin-Angiotensin-Aldosterone System Contribution to Racial Differences in Cardiovascular Risk in Normotensive AdolescentsAuthors: Chandra Sekhar P, Pedersen-White J, Harshfield G

Purpose: “To evaluate RAAS (reninangiotensin-aldosterone system) contribution to racial differences in blood pressure (BP) in normotensive adolescents.”

Results: Using a controlled sodium diet, researchers “examined 84 normotensive adolescents, age 15—18 years (47 African-American, 37 Caucasian),” measuring resting BP, urinary sodium excretion, plasma renin activity, plasma angiotensin-II, plasma aldosterone, and taking “a 2-D echocardiogram on all subjects to calculate left ventricular mass.” Their measurements lead researchers to conclude that “dysregulation of RAAS influences the development of increased LVM in normotensive AA adolescents,” suggesting “that non suppressible Ang II levels in AA may contribute directly and/or indirectly to increased LVM and earlier cardiovascular damage.”

Abstract #824Central Diabetes Insipidus in a Patient with Acute Myeloid Leukemia Associated with Chromosome 3 Inversion and Chromosome 7 MonosomyAuthors: Apaza Concha A, Sosa-Melo A, del Pilar Solano M

Purpose: “To report a case of Central Diabetes Insipidus (CDI) in a 21-year-old African American male as a complication of Acute Myeloid Leukemia (AML).”

Results: “AML associated to CDI is a rare syndrome and the association with chromosome 7 monosomy and chromosome 3 inversion carries worse prognosis. Diabetes Insipidus is a hazardous clinical presentation that needs to be suspected and recognized in order to be appropriately managed.”