Quantifying fluctuation in glucose levels to identify early changes in glucose homeostasis in cystic fibrosis

Abstract

Glucose fluctuation on CGMS can be quantified by calculating the IQR. This information may improve early recognition of abnormal glucose homeostasis.

Continuous glucose monitoring guided insulin therapy is associated with improved clinical outcomes in cystic fibrosis-related diabetes

“…[16] A number of other CGM parameters have been suggested including the presence of any reading N11 mmol/L [19,20], mean glucose [13], and more recently the usefulness of interquartile range and glycaemic variability have been introduced. [21,22] A threshold based on a continuous outcome (e.g. % time spent N7.8 mmol/L) rather than binary outcome (e.g.…”

Cystic fibrosis year in review 2018, part 2

“…Glucose abnormalities in patients with CF are better understood due to the use of continuous glucose monitoring (CGM). 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 .…”

“…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.…”

Intermittent Use of Continuous Glucose Monitoring: Expanding the Clinical Value of CGM

“…For example, clinical symptoms of diabetes, which is present in 20%-50% of youths/adults with CF, typically progress slowly and sometimes insidious, and glucose abnormalities cannot be detected sufficiently with diagnostic measures like an oral glucose tolerance test. 88-92 It has also been shown in youth that high glycemic excursions correlate with a decline of lung function. 93 CGM-guided insulin therapy is associated with improved clinical outcomes as weight gain and pulmonary parameters.…”