Continuous glucose monitoring abnormalities in cystic fibrosis youth correlate with pulmonary function decline

Abstract

CFNG youth have higher glucoses and glucose variability than HC on CGM. Higher and more variable glucoses correlate with lung function decline. Whether earlier treatment of CGM abnormalities improves lung function in CF requires further study.

Diagnosis, Therapy and Follow-Up of Diabetes Mellitus in Children and Adolescents

“…Since diabetes in cystic fibrosis is often clinically difficult to detect, children with cystic fibrosis as of age 10 should receive an oral glucose tolerance test annually [Lanng et al 1994]. New studies show better results using CGM to detect glucose variability [Chan et al, (2018)].…”

Cystic fibrosis year in review 2018, part 2

“…Using CGM, an evaluation of the glucose variability, the calculated interquartile range, was found to have 60% sensitivity and 98% specificity for identifying CFRD Positive predictive value for a diagnosis of CFRD was found to be 93% while negative predictive value was 83% . In patients aged 10 to 17 years, other CGM measures, hyperglycemia and glycemic variability, were found to be associated with FEV1pp and FVCpp decline in the prior year, but not weight or BMI z ‐score change . In adults, patients with higher CGM values, had poorer baseline lung function (by almost 20%), lower weight (~8 kg) and steeper FEV1pp decline (−1.34%).…”

“…28 In patients aged 10 to 17 years, other CGM measures, hyperglycemia and glycemic variability, were found to be associated with FEV1pp and FVCpp decline in the prior year, but not weight or BMI z-score change. 29 In adults, patients with higher CGM values, had poorer baseline lung function (by almost 20%), lower weight (~8 kg) and steeper FEV1pp decline (−1.34%). Treatment with insulin led to improvements in FEV1pp (+4.3%) and weight (+1.2 kg) during the initial treatment phase (3 months) with no further increases through 12 months and therefore led to a reduced rate of FEV1pp decline.…”

“…IQR] 1301 kcal/d vs 686; P < .0001) and proportion of energy intake (median [IQR] 44%[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] vs 31%[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]; P < .0001). Thus, while children with CF met their energy requirements and ate ample fat, this was largely due to ingestion of EDNP foods.…”

Epidemiološke i kliničke karakteristike cistične fibroze u odrasloj dobi

“…Bolesnici stvaraju dovoljno enzima i nemaju malapsorpciju (PS bolesnici) (10). Dijagnoza akutnog pankreatitisa (AP) kod ovih bolesnika postavlja na osnovu prisustva dva od tri data kreterijuma: akutna abdominalna bola sa ili bez povraćanja, trostruko povišene vrijednosti amilaza i/ili lipaza u serumu, (13). Hronična inflamacija doprinosi nastanku epizodnih artritisa koji se javljaju početkom adolescencije i nisu vezani za težinu plućne bolesti.…”