Drug treatments for managing cystic fibrosis-related diabetes

Onady, Gary M.; Stolfi, Adrienne

doi:10.1002/14651858.cd004730.pub5

Cited by 13 publications

(15 citation statements)

References 53 publications

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“…The results from our study are consistent with the findings of the most recent Cochrane review, in that no significant treatment effect of insulin was seen on FEV 1 or BMI after the first 24 months of treatment [14].…”

Section: Discussionsupporting

confidence: 92%

“…weight and/or lung function following insulin initiation in people with CFRD [9][10][11], there have been few prospective clinical trials [12,13]. A recent Cochrane systematic review identified just four studies suitable for inclusion, and only one measured outcomes beyond 12 months [12,14]. The benefits observed in small observational studies have not been replicated in clinical trials, and the Cochrane review found no evidence of a benefit for insulin over oral hypoglycaemic agents [14].…”

Section: Introductionmentioning

confidence: 99%

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The long-term effects of insulin use in incident cystic fibrosis-related diabetes: a target trial emulated using longitudinal national registry data

2022

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IntroductionCystic fibrosis-related diabetes (CFRD) is a common complication of cystic fibrosis and is associated with deleterious clinical outcomes. Insulin is recommended as a treatment by international guidelines. However, there are scarce clinical trial data to support the use of insulin, and little is known about the long-term outcomes of treatment. The aim of this study was to compare the long-term impacts of insulin useversusnon-use in CFRD.MethodsWe used data from the national UK Cystic Fibrosis Registry and adopted a target trial framework. Eligible individuals included those 12 years and older with a new diagnosis of CFRD. Outcomes were change in % predicted forced expiratory volume in 1 s (FEV1%) and body mass index z-scores (BMI) over a 5-year follow-up period. Treatment strategies were to receive insulin or not for the duration of follow-up. Treatment effect estimates were obtained using two methods to control for confounding: inverse-probability-of-treatment weighted estimation of marginal structural models and the G-formula.ResultsWe identified 1613 individuals diagnosed with CFRD between 2008 and 2016 and included 1196 and 1192 in the FEV1% and BMI outcome analyses respectively. We found no evidence of an effect of insulin on FEV1% over the 5-year study period. Similarly, we found no overall effect of insulin on BMI; however, there was some evidence for a positive treatment effect in patients with lower baseline BMI.ConclusionUsing well-established national registry data, we found no evidence of long-term treatment effects for insulin on FEV1% or BMI in people with incident CFRD.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The long-term effects of insulin use in incident cystic fibrosis-related diabetes: a target trial emulated using longitudinal national registry data

2022

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“…En los pacientes que presentan este síndrome, se ha utilizado Cisaprida, que ha demostrado que disminuye la sintomatología gastrointestinal (15). Aunque en los casos de pacientes con fibrosis quística que presentan diabetes se prefiere un tratamiento hipoglucemiante oral, según las guías americanas de la Cystic Fibrosis Foundation, se prefiere el uso de insulina (16). La administración de vitamina K, debido a la deficiencia en la absorción de vitaminas liposolubles, es un tema a discusión; puesto que los pacientes que la consumen tienen menor probabilidad de fractura de cadera, gracias a la disminución de la osteocalcina descarboxilasa (sustancia indicadora del riesgo de fractura de cadera) (17).…”

Section: Resultados Y Discusiónunclassified

La evolución del manejo de la fibrosis quística. revisión bibliográfica

Pesántez

2022

Gac Méd Caracas

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“…This is not only due to the importance of insulin in CFRD but also inadequate data to recommend the use of other diabetes therapeutics, 163 and concerns regarding side effects. New data may support use of non‐insulin medications in well‐defined circumstances 164,165 . However, there are only a limited number of studies in the area to guide clinical practice.…”

Section: Treatment Of Cfrdmentioning

confidence: 99%