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PO-0064 Cystic Fibrosis Related Diabetes In Adolescents
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  1. D Virlan1,
  2. L Sochirca1,
  3. A Chiriac2,
  4. S Sciuca3
  1. 1Department of Pediatrics, State Medical and Pharmaceutical University Nicolae Testemitanu, Chisinau, Moldova
  2. 2Department of Endocrinology, National Children’s Hospital "Emilian Cotaga", Chisinau, Moldova
  3. 3Cystic Fibrosis Center, Mother and Child Center, Chisinau, Moldova

Abstract

Background Cystic fibrosis related diabetes (CFRD) is a combination between reduced insulin secretion and peripheral insulin resistance that only people with cystic fibrosis can get. CFRD is associated with a decline in lung function, poor nutritional status and high mortality rate.

Aim Study of the clinical course and therapeutic management in adolescents with CFRD.

Methods We present 2 cases of CFRD in a female patient (15 years old) and a male patient (17 years old) hospitalised at the CF Centre. The diagnosis of CF was confirmed by positive sweat test (Macroduct USA), identification of CFTR mutation (F508del/F508del), small amounts of elastase in stool. Confirmation of diabetes was achieved by a blood glucose test, blood glucose profile, glycosylated Hb, C peptide, glucose and ketones in urine.

Results On the background of pulmonary exacerbation, both patients had hyperglycemia (9.8/14.1 mmol/l). Subsequently, it triggered clinical syndromes suggestive for diabetes - polydipsia, polyuria, weight loss. Glycemic profile variations 7.8–15.8 mmol/l in boy and 10.4–21.0 mmol/l in girl. Glycosylated Hb values were high (7.3/14.1%) and C-peptide values were low (0.624/0.513). Glucose concentration in urine was 7.3/37.1 g/l and ketones was not detected. Diabetes treatment was performed with Insulin (Glargine, Aspart, Human), which produced clinical benefits by achieving glycemic and clinical syndromes control.

Conclusions Patients with CFRD shows a specific clinical framework and require a strict medical diet control and surveillance of the insulin therapy, case that differs from the other types of diabetes. If early introduced, it significantly improves life expectancy towards these patients.

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