title: Outcome of cystic fibrosis-related diabetes two years after lung transplantation.
abstract: BACKGROUND
  Although transplantation is known to impair glucose tolerance, evolution of pre-existing diabetes after lung transplantation (LT) in cystic fibrosis (CF) has never been described.
  
  
  OBJECTIVE
  We aimed to assess the outcome of CF-related diabetes (CFRD) after LT, with the hypothesis that suppressing chronic inflammatory foci may improve glucose tolerance in some patients.
  
  
  METHODS
  In a retrospective study of 29 CF diabetic patients treated with insulin and undergoing LT, CFRD control was assessed 3 months before LT and 1 (n = 27) and 2 (n = 18) years after LT by measuring insulin dosage, fasting blood glucose and glycosylated hemoglobin (HbA1c) levels. Patients with HbA1c ≤7% and an insulin dose ≤1 UI/kg/day were defined as having controlled CFRD (group A). Other patients were assigned to group B.
  
  
  RESULTS
  Before LT, 19 (65.5%) patients were in group A. At 2 years, 6 of 10 (60%) patients who were in group B prior to LT had moved into group A, which then comprised 77.8% of all patients. Insulin could have been stopped in 5 patients. Uncontrolled CFRD before LT (OR = 16) and a long delay between the diagnosis of CFRD and LT (OR = 1.3) were significant predictors of uncontrolled CFRD at 1 year.
  
  
  CONCLUSIONS
  LT does not seem to worsen CFRD in some patients, suggesting that in some cases, glucose tolerance may be improved by the suppression of chronic pulmonary infection.
authors.affiliation: Department of Internal Medicine Adult Cystic Fibrosis Care Center, Lyon, France. florent.valour@chu-lyon.fr
authors.forename: Florent
authors.initials: F
authors.lastname: Valour
authors.forename: Coralie
authors.initials: C
authors.lastname: Brault
authors.forename: Fatima
authors.initials: F
authors.lastname: Abbas-Chorfa
authors.forename: Christine
authors.initials: C
authors.lastname: Martin
authors.forename: Laurence
authors.initials: L
authors.lastname: Kessler
authors.forename: Reem
authors.initials: R
authors.lastname: Kanaan
authors.forename: Hélène
authors.initials: H
authors.lastname: Mosnier-Pudar
authors.forename: Bérengère
authors.initials: B
authors.lastname: Coltey
authors.forename: Raphaële
authors.initials: R
authors.lastname: Nove-Josserand
authors.forename: Stéphane
authors.initials: S
authors.lastname: Durupt
authors.forename: Cyrille
authors.initials: C
authors.lastname: Colin
authors.forename: Isabelle
authors.initials: I
authors.lastname: Durieu
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D001786:Blood Glucose; D003550:Cystic Fibrosis / Q000150:complications / Q000601:surgery*; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D018450:Disease Progression; D010188:Exocrine Pancreatic Insufficiency / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D000078790:Insulin Secretion; D016015:Logistic Models; D016040:Lung Transplantation; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007166:Immunosuppressive Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human