ESPE Abstracts (2014) 82 P-D-1-3-89

Nutritional Status and Respiratory Function in Patients Affected by Cystic Fibrosis and Glucose Metabolism Derangements after 4 Years of Insulin Therapy with Glargine

Enza Mozzilloa,b, Valeria Raiaa, Valentina Fattorussoa, Carla Cerratoa, Elena De Nittoa, Fabiola De Gregorioa, Angela Sepea, Giuliana Valeriob & Adriana Franzesea


aSection of Pediatrics, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; bDepartment of Movement Sciences, Parthenope University of Naples, Naples, Italy


Background: The glucose metabolism derangements (GMD) can have an important impact on nutritional status and respiratory function in patients with cystic fibrosis (CF).

Objective and hypotheses: The aim of our study is to evaluate the effects of 4 years of glargine therapy in patients affected by CF and GMD.

Method: All CF patients attended to the Center of Cystic Fibrosis of our department were screened by oral glucose tolerance test. All CF subjects showing the following GMD were enrolled into a protocol of treatment with insulin glargine: cystic fibrosis related diabetes (CFRD), patients with glycemia at T0′ >126 mg/dl and/or T120′ >200 mg/dl; impaired glucose tolerance (IGT), patients with glycemia at T120′ >140 mg/dl; abnormal glucose tolerance (AGT), patients with glycemia at T30′ and/or T60′ and/or T90′ >140 mg/dl. The starting dose was 0.2 UI/kg per day. Eighteen patients with GMD (6-CFRD, 6-IGT, 6-AGT), mean age 10.7±2.4 years at the beginning of the study, completed 4 years of treatment with glargine (average dose: 0.22 IU/kg per day, range: 0.11–0.24). BMI, BMI Z-score, forced expiratory volume in the first second (FEV1%) and number of respiratory exacerbations/year were assessed longitudinally by 2 years before the beginning of therapy to 4 following years.

Results: Longitudinal alterations of analysed parameters (mean±S.D.) are in the table.

Table 1.
−2 years−1 years0+1 years+2 years+3 years+4 yearsP
BMI16.3±2.516.5±2.417.1±2.518±2.718.7±2.619.1±2.519.4±2.5<0.05
BMIz-s−0.3±1.1−0.3±0.9−0.2±0.8−0.1±0.9−0.07±0.8−0.1±0.7−0.2±0.7ns
FEV1%95.3±3.493.1±17.891.6±19.294.7±1991.9±18.391.1±21.694.3±15.3ns
Exac/year2±1.41.9±1.51.5±11.3±1.11.5±1.21.3±1.31.1±1.2<0.05

Conclusion: Glargine treatment seems to reduce the number of pulmonary exacerbations in patients affected by CF and GMD; moreover it seems to retard the decay of nutritional parameters and of respiratory function.