[Continuous glucose monitoring system in the screening of glucose disorders in cystic fibrosis].
BACKGROUND
Diabetes mellitus (DM) is an increasing complication of cystic fibrosis (CF). It is associated with enhance morbidity. Continuous glucose monitoring system (CGMS) could detect glucose disorders earlier than other screening tests usually used.


OBJECTIVE
To compare oral glucose tolerance test (OGTT), HbA(1c) and CGMS in patients with CF and recent disorders of glucose homeostasis and to analyse changes in nutritional status and/or pulmonary function.


METHODS
Thirteen patients with CF (11-22 years, 7 males) were studied using OGTT, HbA(1c) and CGMS. All of them had newly diagnosed glucose disturbances. They were not receiving steroid therapy or had an underlying illness. In all subjects we compared: HbA(1c) levels (%), fasting and 2-hours glucose OGTT (mg/dl) and glucose CGMS values (overall, fasting, 2-hours post mean-meals and excursions >140mg/dl at any time). Furthermore, body mass index, forced expiratory volume in the first second (%) and forced vital capacity (%) were evaluated in the previous year and at the time of the study. We also analysed exocrine pancreatic function and CF-mutation.


RESULTS
Mean age at diagnosis of glucose disturbance was 16.4 years. All patients had insufficient exocrine pancreatic function and 11/13 presented DeltaF508 CF-mutation. Only one patient was diagnosed with DM using OGGT and 7/13 (53.8%) with CGMS. A total 77% of patients had poor nutritional status and/or pulmonary function at time of diagnosing the glucose disorder. Only 4 patients had abnormal HbA(1c) levels.


CONCLUSIONS
CGMS allows a better detection of glucose disorders than OGTT. Glucose homeostasis abnormalities are associated with a decrease in nutritional status and/or pulmonary function. HbA(1c) does not aid in the early diagnose of glucose disorders.
Martín-Frías
M
M
Unidad de Diabetes Pediátrica, Servicio de Pediatría, Hospital Universitario Ramón y Cajal, Universidad Alcalá de Henares, Madrid, España. maria.martin.sg@hotmail.com
Lamas Ferreiro
A
A
Colino Alcol
E
E
Alvarez Gómez
M A
MA
Yelmo Valverde
R
R
Barrio Castellanos
R
R
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D002648:Child; D003550:Cystic Fibrosis / Q000097:blood* / Q000150:complications*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D012189:Retrospective Studies; D055815:Young Adult
D001786:Blood Glucose; D005947:Glucose