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: 0.110.24). 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.
|−2 years||−1 years||0||+1 years||+2 years||+3 years||+4 years||P|
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.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology