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Continuous glucose monitoring to evaluate glycaemic abnormalities in cystic fibrosis
  1. Mariana Zorrón Mei Hsia Pu1,
  2. Aline Cristina Gonçalves1,
  3. Walter José Minnicucci2,
  4. André Moreno Morcillo1,
  5. José Dirceu Ribeiro1,
  6. Antonio Fernando Ribeiro1
  1. 1Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil
  2. 2Department of Clinical Medicine, University of Campinas, Campinas, SP, Brazil
  1. Correspondence to Dr Mariana Zorrón Mei Hsia Pu, Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-970, Brazil; marianazorron{at}yahoo.com.br

Abstract

Objective This study aimed to determine the glycaemic profile of patients with cystic fibrosis using a continuous glucose monitoring system (CGMS), and to evaluate the associations of glycaemic abnormalities with sex, age, pubertal stage, CFTR gene mutations, nutritional status, lung function, oral glucose tolerance test, glycated haemoglobin concentrations, fasting insulin concentrations, C peptide concentrations and exocrine pancreatic function.

Study design This observational study evaluated CGMS data from 39 patients with cystic fibrosis who were treated at a referral centre. The patients were 10–19.9 years old, and were categorised according to whether they had normal results (27 patients) or glucose intolerance (12 patients) during the oral glucose tolerance test.

Results The maximum interstitial glucose concentration among individuals with normal oral glucose tolerance test results was 174.9±65.1 mg/dL (9.7–3.61 mmol/L), compared with 170.4±40.9 mg/dL (9.46–2.27 mmol/L) among individuals with glucose intolerance. The CGMS revealed that 18 of the 27 patients with normal oral glucose tolerance test results had peak interstitial glucose concentrations of >140 mg/dL (7.8 mmol/L), and that 4 of these individuals had peak levels of >200 mg/dL (11.1 mmol/L). None of the analysed clinical or laboratory characteristics predicted the occurrence of hyperglycaemic peaks on CGMS.

Conclusions The present study revealed that CGMS could detect hyperglycaemia among patients with cystic fibrosis and ‘normal’ oral glucose tolerance test results, and that their clinical and laboratory characteristics were not useful in discerning between patients who did and did not exhibit these excursions.

  • cystic fibrosis
  • diabetes
  • glucose metabolism disorders
  • continuous glucose monitoring

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Footnotes

  • Contributors MZMHP and AFR conceived the study, interpreted the data and drafted the manuscript. MZMHP sourced the data. MZMHP, AFR, ACG and WJM reviewed the medical details of each case. AMM conducted the statistical analysis. JDR and AFR reviewed the manuscript. MZMHP designed the study, interpreted the data and critically reviewed the manuscript, and is the corresponding author of this manuscript. All authors approved the final manuscript as submitted.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained from the parents/guardian.

  • Ethics approval This study protocol was approved by the Ethics Committee of the Faculty of Medical Sciences (757.539). The protocol complied with the ethical principles out in the Declaration of Helsinki II and Resolution 196/96 of the National Research Ethics Committee.

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

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