Comparison of Continuous Glucose Monitoring in Cystic Fibrosis Patients With or Without Pancreatic Exocrine Insufficiency

Author:

Rakotoarisoa Luc12ORCID,Weiss Laurence3,Lefebvre François4,Porzio Michele3,Ravoninjatovo Bruno5,Abely Michel5,Boucher Isabelle Danner6,Dubois Séverine7,Troussier Françoise8,Gilles Rault9,Prevotat Anne10,Kessler Laurence12

Affiliation:

1. Department of Diabetology, University Hospital Strasbourg, Strasbourg, France

2. Inserm UMR 1260, Regenerative Nanomedicine, University of Strasbourg, Strasbourg, France

3. CRCM, University Hospital Strasbourg, Strasbourg, France

4. GMRC, University Hospital Strasbourg, Strasbourg, France

5. CRCM, University Hospital Centre Reims, Reims, France

6. Pneumology, University Hospital Centre Nantes, Nantes, France

7. Diabetology, University Hospital Centre Angers, Angers, France

8. CRCM, University Hospital Centre Angers, Angers, France

9. CRCM, Centre de Perharidy, Roscoff, France

10. Allergology, Lille University Hospital Center, Lille, France

Abstract

AbstractThis study aimed to compare continuous glucose monitoring (CGM) in cystic fibrosis (CF) according to pancreatic exocrine status.CGM and oral glucose tolerance testing (OGTT) were realized annually over five years in people with CF (pwCF) aged≥10 years without cystic fibrosis-related diabetes (CFRD). CGM parameters in patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and newly diagnosed CFRD were compared according to presence of pancreatic sufficiency (PS) or insufficiency (PI).Overall, 547 OGTTs and 501 CGMs were performed in 147 CF patients, comprising 122 PI and 25 PS. In PS patients, 84% displayed NGT, 12% IGT, and 4% CFRD vs. 58%, 32%, and 10% (p=0.05) in PI. Among participants displaying normal OGTT, time in glucose range (70–140 mg/dl) was significantly increased, 97% (93, 99) vs. 92% (85, 96), p<0.001, and time above glucose range > 140 mg/dl significantly decreased, 1% (0, 2) % vs. 6% (2, 13), in patients with PS compared to those with PI. No significant differences were highlighted in patients with IGT.CGM revealed significant different glucose tolerance abnormalities in PI versus PS, which were undetected by standard 2-hour OGTT glucose.

Funder

Association Vaincre la Mucoviscidose

Association ADIRAL

Publisher

Georg Thieme Verlag KG

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,General Medicine,Endocrinology, Diabetes and Metabolism

Reference21 articles.

1. Epidemiology, Pathophysiology, and Prognostic Implications of Cystic Fibrosis-Related Diabetes;A Moran;Diabetes Care,2010

2. Pancreatic Pathophysiology in Cystic Fibrosis;K N Gibson-Corley;The Journal of Pathology,2016

3. Diabetes mellitus in cystic fibrosis is characterized by islet amyloidosis;M Couce;Journal of Clinical Endocrinology and Metabolism,1996

4. Clinical Care Guidelines for Cystic Fibrosis-Related Diabetes: A position statement of the American Diabetes Association and a clinical practice guideline of the Cystic Fibrosis Foundation, endorsed by the Pediatric Endocrine Society;A Moran;Diabetes Care,2010

5. Accelerated Red Blood Cell Turnover Can Invalidate the Use of Hemoglobin A1c as a Diagnostic Test for Cystic Fibrosis Related Diabetes;D S Hardin;Pediatric Research,1999

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