Association of reactive hypoglycemia with body mass index, homeostatic model assessment of insulin resistance and comorbidity

INTRODUCTION: Untreated hypoglycemia at profoundly low levels restrains the delivery of energy to vital organs and causes a series of extreme adverse events, ultimately resulting in coma and death. The purpose of the study was to determine the relationship between body mass index (BMI), homeostatic model assessment of insulin resistance (HOMA-IR), and co-morbidities in patients experiencing hypoglycemia during an oral glucose tolerance test (OGTT).
METHODS: We retrospectively analyzed the medical records of all patients presented to the diet outpatient clinic between 2015 and 2020 for OGTT. After an overnight fast of 10-12 hours, the patient’s fasting insulin (HOMA-IR) and fasting glucose were recorded. A 330cc solution of glucose (containing 75 grams of dextrose anhydride) drink was used for the OGTT. Following this, blood glucose was measured at 30, 60, 120, 180, and 240 minutes. The obtained data were analyzed using descriptive and inferential statistics.
RESULTS: A total of 614 patients were analyzed. A positive correlation was found between BMI and HOMA-IR (p≤0.001), BMI and blood glucose (p≤0.001). Although hypoglycemia rates were higher in overweight and obese patients, the difference was not significant (p= 0.316). The presence of co-morbidity did not affect the incidence of hypoglycemia (p=0.413).
DISCUSSION AND CONCLUSION: We observed that increased BMI was associated with having HOMA-IR and high glucose levels at 0-30-60-120 minutes in OGTT. Although hypoglycemia during the OGTT was not associated with BMI in this study, large-scale studies are needed to reveal this relationship.