title: Early assessment of glucose abnormalities during continuous glucose monitoring associated with lung function impairment in cystic fibrosis patients.
abstract: BACKGROUND
  Cystic fibrosis-related diabetes (CFRD) is correlated with a decline in lung function. Under certain circumstances, oral glucose tolerance test (OGTT) screening, used to diagnose CFRD, fails to reveal early glucose tolerance abnormalities. In this situation, continuous glucose monitoring (CGM) could be a useful tool for evaluating early abnormalities of glucose tolerance in CF patients. We aimed to study the CGM glucose profile in CF patients with normal OGTT screening results and to evaluate lung function and nutritional status according to the CGM glucose profile.
  
  
  METHODS
  We assessed glycemic control, the CGM glucose profile, nutritional status, lung function antibiotic courses and colonization (P. aeruginosa and S. aureus) in CF patients, aged 10 years and over, with normal screening OGTT results (blood glucose at T120 min < 7.8 mmol/l). Two groups were identified according to the max CGM glucose value: Group 1<11 mmol/l and Group 2 ≥ 11 mmol/l.
  
  
  RESULTS
  Among the 38 patients with normal OGTT, 12 (31.6%) were in Group 2. Compared to Group 1, Group 2 patients exhibited a significant impairment in lung function: FEV1, 68.2 ± 25.6% vs. 87.3 ± 17%, p = 0.01 and FVC, 86.1% ± 19.4% vs. 99.3% ± 13.4%, p=0.021, as well as a higher rate of colonization by P. aeruginosa: 83.3% vs. 44%, p=0.024. Nevertheless, there were no differences in nutritional status (BMI standard deviation score: p = 0.079; prealbumin: p = 0.364).
  
  
  CONCLUSIONS
  CGM reveals early abnormalities of glucose tolerance that remain undiagnosed by OGTT screening and are associated with worse lung function and a higher prevalence of P. aeruginosa colonization in patients with CF.
  
  
  BACKGROUND
  NCT00476281.
authors.affiliation: Service de pneumologie et CRCM adulte, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67091 Strasbourg, France. Electronic address: aleclercq1@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Leclercq
authors.affiliation: CRCM, Hôpitaux Universitaires de Reims, 47, rue Cognacq-Jay, 51092 Reims, France.
authors.forename: B
authors.initials: B
authors.lastname: Gauthier
authors.affiliation: Service de pneumologie et CRCM adulte, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67091 Strasbourg, France.
authors.forename: V
authors.initials: V
authors.lastname: Rosner
authors.affiliation: CRCM pédiatrique, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67098 Strasbourg, France.
authors.forename: L
authors.initials: L
authors.lastname: Weiss
authors.affiliation: Service d'endocrinologie et de diabétologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67091 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Moreau
authors.affiliation: EA 7293, Vascular and Tissue Stress in Transplantation, Federation of Translational Medicine of Strasbourg, University of Strasbourg, France; Department of Parasitology and Parasitic Diseases and Animal Biology, Faculty of Veterinary Medicine, University of Agronomical Sciences and Veterinary Medicine, Bucharest, Romania.
authors.forename: A A
authors.initials: AA
authors.lastname: Constantinescu
authors.affiliation: Service de pneumologie et CRCM adulte, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67091 Strasbourg, France.
authors.forename: R
authors.initials: R
authors.lastname: Kessler
authors.affiliation: Service d'endocrinologie et de diabétologie, Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67091 Strasbourg, France; EA 7293, Vascular and Tissue Stress in Transplantation, Federation of Translational Medicine of Strasbourg, University of Strasbourg, France.
authors.forename: L
authors.initials: L
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology*; D005602:France / Q000453:epidemiology; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D015995:Prevalence; D011446:Prospective Studies; D012129:Respiratory Function Tests; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: CGM; Cystic fibrosis; Early glucose tolerance abnormalities; Lung function; OGTT