ABSTRACT
Introduction: Patients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. Objective: To compare OGTT and CGM results in CF patients. Methods: Paired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10-18 years. Results: According to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%-14% with NGT, 1%-16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD). According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. Conclusions: OGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients (AU)
Introducción: Los pacientes con fibrosis quística (FQ) evolucionan lenta y progresivamente hacia la diabetes, siendo el test de tolerancia oral a la glucosa (TTOG) el método utilizado para diagnosticar sus alteraciones glucémicas. La monitorización continua de glucosa (MCG) proporciona perfiles de glucosa en condiciones de vida habituales del paciente. Objetivo: Comparar los resultados del TTOG y de la MCG en pacientes con FQ. Métodos: TTOG seguido de MCG (146,2±9,1h/paciente) en 30 pacientes con FQ (10-18 años de edad). Resultados: Según el TTOG, 14 pacientes presentaron tolerancia normal a la glucosa (TNG), 14 tolerancia anormal a la glucosa (TAG) y 2 diabetes relacionada con la fibrosis quística (DRFQ). En 27 pacientes (13 con TNG, 13 con TAG, uno con DRFQ) la MCG mostró valores de glucosa 140-200mg/dL durante periodos similares de tiempo (2-14%, 1-16,9% y 3%, respectivamente). Picos de glucosa ≥200mg/dL se observaron en 7 pacientes (3 con TNG, 3 con TAG y uno con DRFQ). Según la MCG, 2 pacientes tuvieron todos los valores de glucosa <140mg/dL (uno con TNG y otro con TAG); 17 pacientes entre 140-200mg/dL (10 con TNG, 6 con TAG y uno con DRFQ); 10 pacientes ≥200mg/dL durante ≤1% del tiempo valorado (3 con NGT, 7 con TAG) y uno ≥200mg/dL durante >1% del tiempo valorado (con DRFQ). Conclusiones: Los resultados del TTOG no concuerdan con los de la MCG. La MCG permite el diagnóstico de anomalías de la glucosa no detectadas mediante el TTOG y sus resultados podrían contribuir a optimizar el tratamiento de la prediabetes en estos pacientes (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Glucose Tolerance Test/methods , 34628 , Diabetes Mellitus/diagnosis , Cystic Fibrosis/diagnosis , Blood Glucose Self-Monitoring/methods , Data Analysis/methodsABSTRACT
INTRODUCTION: Patients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions. OBJECTIVE: To compare OGTT and CGM results in CF patients. METHODS: Paired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10-18 years. RESULTS: According to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%-14% with NGT, 1%-16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD). According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time. CONCLUSIONS: OGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients.
Subject(s)
Blood Glucose Self-Monitoring , Cystic Fibrosis/complications , Glucose Intolerance/diagnosis , Glucose Tolerance Test , Adolescent , Blood Glucose , Blood Glucose Self-Monitoring/instrumentation , Blood Glucose Self-Monitoring/methods , Child , Diabetes Mellitus/blood , Diabetes Mellitus/diagnosis , Diabetes Mellitus/etiology , Disease Progression , Early Diagnosis , Fasting/blood , Female , Glucose Intolerance/blood , Glucose Intolerance/etiology , Humans , Male , Prediabetic State/blood , Prediabetic State/diagnosis , Prediabetic State/etiology , Prospective StudiesABSTRACT
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