Conventional measures underestimate glycaemia in cystic fibrosis patients

Dobson, Lee; Sheldon, Christopher; Hattersley, Andrew T.

doi:10.1111/j.1464-5491.2004.01219.x

Cited by 105 publications

(96 citation statements)

References 37 publications

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“…This technology has similarly been used in hyperglycemia in type 1 diabetic subjects using insulin pump therapy (65,66), type 1 diabetic subjects using insulin injections (67), pregnant women with (55)(56)(57)(58)(59)68) and without (68,69) diabetes, gastroparesis patients (70), and cystic fibrosis patients (71). Continuous glucose monitoring has also been used as a therapeutic tool to decrease the incidence and magnitude of hypoglycemia in three studies (46,72,73).…”

Section: Continuous Glucose Monitoringmentioning

confidence: 99%

Continuous Glucose Monitoring

2005

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Section: Continuous Glucose Monitoringmentioning

confidence: 99%

Continuous Glucose Monitoring

2005

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“…Therefore, the categories of 'diabetes without fasting hyperglycemia' (15) and of 'indeterminate glucose tolerance' (isolated hyperglycemia at mid-oral glucose tolerance test (OGTT) or continuous glucose monitoring) were established (16). HbA1c is not sensitive in the diagnosis of CFRD (17,18).…”

Section: Introductionmentioning

confidence: 99%

Identification of insulin secretory defects and insulin resistance during oral glucose tolerance test in a cohort of cystic fibrosis patients

Battezzati

Mari

Zazzeron

et al. 2011

European Journal of Endocrinology

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Background: Cystic fibrosis (CF)-related diabetes is a leading complication of CF and is associated with pulmonary and nutritional deterioration, years before an evident hyperglycemia, possibly because of insulin deficiency and resistance. Aim: To evaluate glucose tolerance, insulin secretion, and insulin sensitivity by a widely applicable method suitable for accurate and prospective measurements in a CF population. Methods: A total of 165 CF subjects (80 females) aged 17G5 years and 18 age-and sex-matched healthy controls (CON) received an oral glucose tolerance test with glucose, insulin and C-peptide determinations. Insulin sensitivity was defined on the basis of glucose and insulin concentrations using the oral glucose insulin sensitivity index, whereas b-cell function was determined on the basis of a model relating insulin secretion (C-peptide profile) to glucose concentration. Results: Fifteen percent of CF patients had glucose intolerance and 6% had diabetes without fasting hyperglycemia and 3% had diabetes with fasting hyperglycemia. b-cell function was reduced in CF patients compared with CON (70.0G4.1 vs 117.9G11.6 pmol/min per m 2 per mM, P!0.001) and decreased significantly with age by K2.7 pmol/min per m 2 per mM per year (confidence interval (CI) K4.5 to K0.82), i.e. almost 4% yearly. The early insulin secretion index was also reduced. Insulin sensitivity was similar to CON. CF patients who attained glucose tolerance comparable to CON had lower b-cell function and higher insulin sensitivity. Conclusion: The major alteration in insulin secretion and insulin sensitivity of CF patients is slowly declining b-cell function, consisting of delayed and reduced responsiveness to hyperglycemia, that in CF patients with normal glucose tolerance may be compensated by an increased insulin sensitivity.

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“…The study by Dobson 192,193 was carried out in two stages. First, FOGTTs were undertaken in 20 patients (originally 21, but one dropped out because of venepuncture problems).…”

mentioning

confidence: 99%

Screening for cystic fibrosis-related diabetes: a systematic review.

Waugh

Royle²,

Craigie³

et al. 2012

Health Technol Assess

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Conventional measures underestimate glycaemia in cystic fibrosis patients

Cited by 105 publications

References 37 publications

Continuous Glucose Monitoring

Continuous Glucose Monitoring

Identification of insulin secretory defects and insulin resistance during oral glucose tolerance test in a cohort of cystic fibrosis patients

Screening for cystic fibrosis-related diabetes: a systematic review.

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