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Diabetes outbreak during COVID19 lock-down in a prediabetic patient with cystic fibrosis long treated with glargine.
Rosanio, Francesco Maria; Mozzillo, Enza; Cimbalo, Chiara; Casertano, Alberto; Sepe, Angela; Raia, Valeria; Franzese, Adriana; Tosco, Antonella.
  • Rosanio FM; Regional Center of Pediatric Diabetes, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
  • Mozzillo E; Regional Center of Pediatric Diabetes, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy. mozzilloenza@gmail.com.
  • Cimbalo C; Regional Center of Cystic Fibrosis, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
  • Casertano A; Regional Center of Pediatric Diabetes, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
  • Sepe A; Regional Center of Cystic Fibrosis, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
  • Raia V; Regional Center of Cystic Fibrosis, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
  • Franzese A; Regional Center of Pediatric Diabetes, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
  • Tosco A; Regional Center of Cystic Fibrosis, Department of Translational Medical Science, Section of Pediatrics, Federico II University of Naples, Naples, Italy.
Ital J Pediatr ; 47(1): 121, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1255953
ABSTRACT

BACKGROUND:

Cystic Fibrosis Related Diabetes (CFRD) is a frequent comorbidity of patients with Cystic Fibrosis (CF). A worsening of clinical conditions appears before CFRD. It has been demonstrated a decline in pulmonary function and nutritional status also in patients with prediabetes. Few trials show that insulin may be beneficial in prediabetic CF patients, to date guidelines do not recommend for this condition. CASE PRESENTATION We report a case of a patient treated with insulin glargine at 13 years, due to glycemic intolerance, and with Lumacaftor/Ivacaftor at 15 years. A reduction of pulmonary exacerbations was observed after glargine therapy, also confirmed after the starting of Lumacaftor/ Ivacaftor in this patient. Pulmonary function improved only after the first year of glargine therapy, then a deterioration appeared due to the natural history of CF lung damage. During the COVID-19 lockdown, poor adherence to care contributed to diabetes mellitus onset needing high insulin requirements. After two weeks the patient returned to prediabetic condition and his previous dose of glargine.

CONCLUSIONS:

our case highlights firstly that insulin glargine has contributed to preserve him from further clinical worsening due to prediabetes in the years before pandemic, secondly the negative impact of COVID-19 lockdown on the clinical course of a chronic disease as CF.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cystic Fibrosis / Diabetes Mellitus, Type 1 / Insulin Glargine / COVID-19 / Hypoglycemic Agents Type of study: Case report / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Humans / Male Language: English Journal: Ital J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S13052-021-01076-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cystic Fibrosis / Diabetes Mellitus, Type 1 / Insulin Glargine / COVID-19 / Hypoglycemic Agents Type of study: Case report / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Humans / Male Language: English Journal: Ital J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S13052-021-01076-7