title: Insulin therapy in patients with cystic fibrosis in the pre-diabetes stage: a systematic review.
abstract: OBJECTIVE
  To elucidate whether insulin is effective or not in patients with cystic fibrosis before the diabetes mellitus phase.
  
  
  METHODS
  The study was performed according to the Prisma method between August and September 2014, using the PubMed, Embase, Lilacs and SciELO databases. Prospective studies published in English, Portuguese and Spanish from 2002 to 2014, evaluating the effect of insulin on weight parameters, body mass index and pulmonary function in patients with cystic fibrosis, with a mean age of 17.37 years before the diabetes mellitus phase were included.
  
  
  RESULTS
  Eight articles were identified that included 180 patients undergoing insulin use. Sample size ranged from 4 to 54 patients, with a mean age ranging from 12.4 to 28 years. The type of follow-up, time of insulin use, the dose and implementation schedule were very heterogeneous between studies.
  
  
  CONCLUSIONS
  There are theoretical reasons to believe that insulin has a beneficial effect in the studied population. The different methods and populations assessed in the studies do not allow us to state whether early insulin therapy should or should not be carried out in patients with cystic fibrosis prior to the diagnosis of diabetes. Therefore, studies with larger samples and insulin use standardization are required.
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Campinas (Unicamp), Campinas, SP, Brasil. Electronic address: marianazorron@yahoo.com.br.
authors.forename: Mariana Zorrón Mei Hsia
authors.initials: MZ
authors.lastname: Pu
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Flávia Corrêa
authors.initials: FC
authors.lastname: Christensen-Adad
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Aline Cristina
authors.initials: AC
authors.lastname: Gonçalves
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Walter José
authors.initials: WJ
authors.lastname: Minicucci
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: José Dirceu
authors.initials: JD
authors.lastname: Ribeiro
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Antonio Fernando
authors.initials: AF
authors.lastname: Ribeiro
mesh_terms: D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D011236:Prediabetic State / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Cystic fibrosis; Diabetes melito; Diabetes mellitus; Fibrose cística; Insulin; Insulina