Background: Cystic fibrosis related diabetes (CFRD) is one of the most common complications of CF. CFRD has great impact on progressive deterioration of lung function, poor growth and increased mortality. The need for early detection of disturbance in glucose metabolism was recognized long ago. Current recommendations include screening that begins at age of 10 by performing oral glucose tolerance test (OGTT) but it cannot reveal the initial glucose disturbances. Many centres are using continuous glucose monitoring system (CGMS) to discover hyperglycaemia in real time, during normal activities. There is still no agreement on the application of this method for diagnostic purposes, but it certainly contributes to earlier detection of hyperglycaemia and enables early initiation of insulin therapy.
Objective and hypotheses: The aim of this study was to evaluate profile of glycaemia in patients with CF followed up in a single centre. The indications for CGMS were abnormalities during OGTT or hyperglycaemia detected during regular visits.
Method: Patients were recruited during 2015. Glucose meter and strips were provided to all patients; four blood glucose measurements (BGM) per day were required. CGMS was performed by iPro2 system during 7 days. Patients were instructed to record all BGM and dietary intake in the diary. None of them was on corticosteroid therapy.
Results: Ten patients were included, four males, with a mean age of 22.4 years (11.136.7). In all patients CGMS revealed peaks of glucose higher than 11 mmol/l, after meals even above 19 mmol/l. Asymptomatic hypoglycaemia was noticed in nine patients. In four patients insulin treatment was introduced and all of them changed dietary habits.
Conclusion: We observed abnormal glucose values in almost all patients. According to this experience, it seems that CGMS allows better insight of glucose impairment than OGTT in patients with CF as well as early initiation of insulin therapy.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology