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Abnormal glucose tolerance and lung function in children with cystic fibrosis. Comparing oral glucose tolerance test and continuous glucose monitoring

Abnormal glucose tolerance and lung function in children with cystic fibrosis. Comparing oral glucose tolerance test and continuous glucose monitoring


Title: Abnormal glucose tolerance and lung function in children with cystic fibrosis. Comparing oral glucose tolerance test and continuous glucose monitoring
Author: Elidottir, H.
Diemer, S.
Eklund, E.
Hansen, C. R.
Date: 2021-09
Language: English
Scope: 6
Department: Faculty of Life and Environmental Sciences
Series: Journal of Cystic Fibrosis; 20(5)
ISSN: 1569-1993
DOI: https://doi.org/10.1016/j.jcf.2021.01.002
Subject: Barnalæknisfræði; Slímseigjusjúkdómur; Börn; Abnormal glucose tolerance; Continuous glucose monitoring; Cystic fibrosis related diabetes; Lung clearance index (LCI); Lung function; Oral glucose tolerance test; Pediatrics, Perinatology and Child Health; Pulmonary and Respiratory Medicine
URI: https://hdl.handle.net/20.500.11815/3130

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Citation:

Elidottir , H , Diemer , S , Eklund , E & Hansen , C R 2021 , ' Abnormal glucose tolerance and lung function in children with cystic fibrosis. Comparing oral glucose tolerance test and continuous glucose monitoring ' , Journal of Cystic Fibrosis , vol. 20 , no. 5 , pp. 779-784 . https://doi.org/10.1016/j.jcf.2021.01.002

Abstract:

Background: Cystic fibrosis (CF) related diabetes (CFRD) is a common complication of CF. CFRD is associated with declining lung function even before its onset. Regular screening for CFRD using oral glucose tolerance test (OGTT) is recommended. Additionally, continuous glucose monitoring (CGM) has surfaced as a possible surveillance method, but evidence for its use and concordance with OGTT has not been established. Methods: Children were prospectively recruited at CF center Lund to undergo both intermittent scan CGM (isCGM) and OGTT. Lung function was evaluated by spirometry and multiple breath washout. Demographic and clinical data were collected from the Swedish national CF registry. Results: 32 patients participated in the study, yielding 28 pairs of isCGMs and OGTTs. The OGTTs showed that two patients met the criteria of CFRD, seven had impaired glucose tolerance (IGT) and indeterminate glycemia (INDET) was found in eleven cases. The isCGM percent of measurements >8mmol/L and the number of peaks per day >11 mmol/L have correlations with intermediate OGTT glucose time points, but not the 2hour glucose value. Patients with abnormal glucose tolerance (AGT) had lower lung function than those with normal glucose tolerance demonstrated by both FEV1% predicted and lung clearance index (LCI). Conclusion: Correlations can be found between isCGM and OGTT in regards to the latter's intermediate time points. LCI demonstrates as well as FEV1% of predicted, worse lung function in children and adolescents with abnormal glucose tolerance in CF.

Description:

Funding Information: This research received funding from The Swedish Cystic Fibrosis Association (RfCF). The authors would like to thank all participants, their families and the pediatric CF team at Lund CF center. Dr. B. Jonsdottir is to thank for endocrinological expertise and Clinical Studies Sweden for statistical advice. Publisher Copyright: © 2021

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