title: Increased glucose excursion in cystic fibrosis and its association with a worse clinical status.
abstract: BACKGROUND
  Abnormal glucose tolerance is a frequent co-morbidity in cystic fibrosis patients (CF), and is associated with a worse prognosis. The objectives are to investigate (a) the relative contribution of insulinopenia and insulin resistance (IR) for glucose tolerance and (b) the association between various glucose parameters and CF clinical status.
  
  
  METHODS
  Oral glucose tolerance tests were performed in 114 consecutive CF patients not known to be diabetic as well as 14 controls similar for age and BMI.
  
  
  RESULTS
  Abnormal glucose tolerance was found in 40% of patients with CF: 28% had impaired glucose tolerance (IGT) and 12% had new cystic fibrosis related diabetes (CFRD). Compared to control subjects, all CF patients were characterized by an increased glucose excursion (AUC). While reduced early insulin release characterised CF, IGT and CFRD patients also present IR thus both mechanisms significantly contribute to glucose tolerance abnormalities. Increased glucose AUC and reduced early insulin release but not glucose tolerance categories were associated with a reduced pulmonary function (FEV(1)).
  
  
  CONCLUSIONS
  In CF, early insulin secretion defect but also IR contribute to glucose intolerance. Early in the course of the disease, increased glucose AUC and reduced early insulin secretion are more closely associated with a worse clinical status than conventional glucose tolerance categories.
authors.affiliation: Diabetes Research group, CHUM Research Center Hôtel-Dieu, Montreal QC, Canada H2W 1T7.
authors.forename: Myriam
authors.initials: M
authors.lastname: Costa
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Potvin
authors.forename: Imane
authors.initials: I
authors.lastname: Hammana
authors.forename: Arnaud
authors.initials: A
authors.lastname: Malet
authors.forename: Yves
authors.initials: Y
authors.lastname: Berthiaume
authors.forename: Alphonse
authors.initials: A
authors.lastname: Jeanneret
authors.forename: Annick
authors.initials: A
authors.lastname: Lavoie
authors.forename: Renée
authors.initials: R
authors.lastname: Lévesque
authors.forename: Joëlle
authors.initials: J
authors.lastname: Perrier
authors.forename: Danielle
authors.initials: D
authors.lastname: Poisson
authors.forename: Antony D
authors.initials: AD
authors.lastname: Karelis
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Chiasson
authors.forename: Rémi
authors.initials: R
authors.lastname: Rabasa-Lhoret
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003550:Cystic Fibrosis / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D008297:Male; D011379:Prognosis; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin