Insulin resistance in a young man with cystic fibrosis.
An 18-year-old man had cystic fibrosis (CF) and insulin-resistant carbohydrate intolerance characterized by (1) obesity, basal hyperinsulinemia, and hyperglucagonemia; (2) impaired oral glucose tolerance; (3) hyperinsulinemia in response to oral and intravenous (IV) administration of glucose and to IV administration of tolbutamide; (4) exaggerated gastric inhibitory polypeptide secretion following orally administered glucose; and (5) diminished sensitivity to insulin administered IV compared with other patients with CF. Both parents also demonstrate basal and stimulated hyperinsulinemia in response to orally administered glucose. The long-term outlook for patients with CF is improving, and more patients are surviving childhood. Thus, it should be recognized that an insulin-resistant form of carbohydrate intolerance may develop in patients with CF with obesity and/or genetic risk factors.
D000293:Adolescent; D003550:Cystic Fibrosis / Q000150:complications*; D005749:Gastric Inhibitory Polypeptide / Q000378:metabolism; D005934:Glucagon / Q000097:blood; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications* / Q000235:genetics; D007328:Insulin; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000150:complications; D011972:Receptor, Insulin / Q000378:metabolism
D007328:Insulin; D005749:Gastric Inhibitory Polypeptide; D005934:Glucagon; D011972:Receptor, Insulin