title: Long-term effect of insulin treatment in cystic fibrosis-related diabetes.
abstract: BACKGROUND
  Although insulin treatment confers short-term benefit in cystic fibrosis-related diabetes (CFRD), few studies have compared its long-term effect on the clinical outcome.
  
  
  OBJECTIVE
  In this study, we aimed to investigate the long-term impact of insulin treatment on pulmonary function, nutritional status and hospital admissions in patients with CFRD.
  
  
  METHODS
  We reviewed pulmonary function, body mass index (BMI) and hospital admissions 5 years before and 3 years after insulin therapy in 42 adult CFRD patients.
  
  
  RESULTS
  Prior to treatment, over a period of 5 years, the annual rate of change in forced expiratory volume in 1 s (FEV(1)) was -3.2%, forced vital capacity (FVC) -2.5%, and BMI -0.07%. At treatment of CFRD (baseline), the mean FEV(1) was 51.6% predicted (range 24-96), FVC 66.4% (range 29-103) and BMI 19.5 (range 15.3-29.5). At 3 months following insulin treatment, there was a significant improvement in all parameters, which was maintained at 1 year for FEV(1) (55.1%; p < 0.002), 2 years for FVC (72.1%; p < 0.01) and at 3 years for BMI (20.4%; p < 0.002). After 3 months, FEV(1) declined at a rate similar to that before treatment (-3.2 vs. -3.1% per year; p = 0.77), such that the mean FEV(1) after treatment returned to pretreatment baseline values at 34 months. There was no difference in the number of hospital admissions with insulin treatment.
  
  
  CONCLUSIONS
  Insulin enhances the nutritional state and temporarily improves pulmonary function in CFRD patients, on average delaying the decline in FEV(1) by 34 months.
authors.affiliation: Adult Cystic Fibrosis Unit, The Cardiothoracic Centre NHS Trust, Liverpool, UK.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Mohan
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Israel
authors.forename: Helen
authors.initials: H
authors.lastname: Miller
authors.forename: Ruth
authors.initials: R
authors.lastname: Grainger
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Ledson
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Walshaw
mesh_terms: D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000150:complications*; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D009752:Nutritional Status; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin