María Clemente León1, Laura Bilbao Gassó2, Antonio Moreno-Galdó3, Ariadna Campos Martorrell4, Silvia Gartner Tizzano3, Diego Yeste Fernández5, Antonio Carrascosa Lezcano5. 1. Unidad de Endocrinología, Servicio de Pediatría, Hospital Vall d'Hebron, Grupo de Investigación Crecimiento y Desarrollo, Instituto Investigación Vall d'Hebron (VHIR), CIBER de Enfermedades Raras, Instituto Salud Carlos III, Universitat Autònoma de Barcelona, Spain. Electronic address: mclement@vhebron.net. 2. Unidad de Endocrinología, Servicio de Pediatría, Hospital Vall d'Hebron, Spain. 3. Sección de Alergia Pediátrica, Neumología Pediátrica y Fibrosis quística, Hospital Vall d'Hebron, Grupo de Investigación Crecimiento y Desarrollo, Instituto Investigación Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, Spain. 4. Unidad de Endocrinología, Servicio de Pediatría, Hospital Vall d'Hebron, Grupo de Investigación Crecimiento y Desarrollo, Instituto Investigación Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, Spain. 5. Unidad de Endocrinología, Servicio de Pediatría, Hospital Vall d'Hebron, Grupo de Investigación Crecimiento y Desarrollo, Instituto Investigación Vall d'Hebron (VHIR), CIBER de Enfermedades Raras, Instituto Salud Carlos III, Universitat Autònoma de Barcelona, Spain.
Abstract
INTRODUCTION: Patients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. OBJECTIVE: To compare OGTT and CGM results in CF patients. METHODS: Paired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10-18 years. RESULTS: According to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%-14% with NGT, 1%-16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD). According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. CONCLUSIONS: OGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients.
INTRODUCTION:Patients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. OBJECTIVE: To compare OGTT and CGM results in CFpatients. METHODS: Paired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CFpatients aged 10-18 years. RESULTS: According to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%-14% with NGT, 1%-16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD). According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. CONCLUSIONS: OGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CFpatients.
Authors: J M Milln; E Walugembe; S Ssentayi; H Nkabura; A G Jones; M J Nyirenda Journal: BMC Pregnancy Childbirth Date: 2020-10-19 Impact factor: 3.007