Abnormal Glucose Tolerance and Lung Function in Children wit
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Cystic fibrosis (CF) related diabetes (CFRD) is a common complication of CF. CFRD is associated with declining lung function even before its onset. Regular screening for CFRD using oral glucose tolerance test (OGTT) is recommended. Additionally, continuous glucose monitoring (CGM) has surfaced as a possible surveillance method, but evidence for its use and concordance with OGTT has not been established.

Therefore, researchers examined the utility of CGM and its concordance with OGTT.

They prospectively recruited 32 children to undergo both intermittent scan CGM (isCGM) and OGTT. These patients yielded 28 pairs of isCGMs and OGTTs.

Lung function was evaluated by spirometry and multiple breath washout. Demographic and clinical data were collected from the Swedish national CF registry.

The OGTTs showed that two patients met the criteria of CFRD, seven had impaired glucose tolerance (IGT) and indeterminate glycaemia (INDET) was found in eleven cases. The isCGM per cent of measurements greater than 8mmol/L and the number of peaks per day greater than 11 mmol/L have correlations with intermediate OGTT glucose time points, but not the 2-hour glucose value. Patients with abnormal glucose tolerance (AGT) had lower lung function than those with normal glucose tolerance demonstrated by both FEV1% (forced expiratory volume in one second) predicted and lung clearance index (LCI).

Overall, it was concluded that correlations can be found between isCGM and OGTT in regards to the latter's intermediate time points. LCI demonstrates as well as FEV1% of predicted, worse lung function in children and adolescents with abnormal glucose tolerance in cystic fibrosis.