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Once daily insulin detemir in cystic fibrosis with insulin deficiency
  1. Shihab Hameed1,2,
  2. John R Morton2,3,
  3. Penny I Field3,
  4. Yvonne Belessis2,3,
  5. Terence Yoong3,
  6. Tamarah Katz3,
  7. Helen J Woodhead1,2,
  8. Jan L Walker1,2,
  9. Kristen A Neville1,2,
  10. Thomas A Campbell1,
  11. Adam Jaffé2,3,
  12. Charles F Verge1,2
  1. 1Department of Endocrinology, Sydney Children's Hospital, Randwick, New South Wales, Australia
  2. 2The School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
  3. 3Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia
  1. Correspondence to Dr Shihab Hameed, Department of Endocrinology, Sydney Children's Hospital, Level 4, High Street, Randwick, NSW 2031, Australia; s.hameed{at}unsw.edu.au

Abstract

The aim of this study was to determine if once daily insulin detemir reverses decline in weight and lung function in patients with cystic fibrosis (CF). 12 patients with early insulin deficiency and six with CF related diabetes (aged 7.2–18.1 years) were treated for a median of 0.8 years. Changes in weight and lung function following treatment were compared to pretreatment changes. Before treatment, the change in weight SD score (ΔWtSDS), percentage of predicted forced expiratory volume in 1 s (Δ%FEV1) and percentage of predicted forced vital capacity (Δ%FVC) declined in the whole study population (−0.45±0.38, −7.9±12.8%, −5.8±14.3%) and in the subgroup with early insulin deficiency (−0.41±0.43, −9.8±9.3%, −6.8±10.3%). Following treatment with insulin ΔWtSDS, Δ%FEV1 and Δ%FVC significantly improved in the whole study population (+0.18±0.29 SDS, p=0.0001; +3.7±10.6%, p=0.007; +5.2±12.7%, p=0.013) and in patients with early insulin deficiency (+0.22±0.31 SDS, p=0.003; +5.3±11.5%, p=0.004; +5.8±13.4%, p=0.024). Randomised controlled trials are now needed.

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Footnotes

  • Funding This study was supported by grants from the Sydney Children's Hospital Foundation and the Novo Nordisk Regional Diabetes Support Scheme. SH's fellowship was partly supported by a donation from Novo Nordisk to the Sydney Children's Hospital Foundation. The funding sources played no part in the study design, collection, analysis or interpretation of data, writing of the report, or in the decision to submit the paper for publication.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the South Eastern Sydney Illawarra Area Health Service, Northern Hospital Network, Research Support Office.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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