G144 THE USE OF CONTINUOUS GLUCOSE MONITORING TO DETECT CYSTIC FIBROSIS RELATED DIABETES IN ADOLESCENTS WITH CYSTIC FIBROSIS

R. Pryce¹, M. Pierrepoint², I. Doull¹, I. Bowler³, J. Barton³, J. Hambleton³, S. Hall¹, K. Azzopardi¹, C. Bretland¹, L. Lowes¹, J. W. Gregory¹.¹University Hospital of Wales, Cardiff, UK; ²Nevill Hall Hospital, Abergavenny, UK; ³Royal Gwent Hospital, Newport, UK

Background and Aim: Improved survival in adolescents with cystic fibrosis has led to complications including cystic fibrosis related diabetes. Cystic fibrosis related diabetes is associated with declining respiratory status and weight, higher morbidity, and mortality. These changes may precede abnormalities in glycaemic control detected by the oral glucose tolerance test (OGTT) by up to 4 years. The optimum screening test for cystic fibrosis related diabetes remains controversial and many argue the OGTT is the gold standard. However, there is evidence the OGTT may not detect transient hyperglycaemia and treating these patients improves clinical parameters. We therefore assessed whether continuous glucose monitoring is tolerated in adolescents with cystic fibrosis and whether it is more effective at determining abnormal glucose homeostasis or cystic fibrosis related diabetes than the OGTT.

Methods: This was a prospective pilot study. The continuous glucose monitoring subcutaneous device (Minimed Medtronic) was worn for up to 72 hours while subjects carried out normal activities. The data were compared with capillary blood glucose profiles and OGTT results that identified episodes of fasting, 2 hour post-prandial or casual hyperglycaemia. The subjects completed a questionnaire to determine tolerability of continuous glucose monitoring.

Results: Thirteen subjects completed the study. Seven fulfilled the criteria for cystic fibrosis related diabetes, three for impaired glucose tolerance (as defined by a cystic fibrosis expert committee) and three had normal continuous glucose monitoring studies. Eight subjects had at least one abnormality of OGTT, fasting, …