title: Glucose Fluctuations are Not Modulated by the Proportion of Calories from Macronutrients or Spontaneous Total Energy Expenditure in Adults with Cystic Fibrosis.
abstract: OBJECTIVE
  To determine the modifiable factors affecting glucose variability in people with cystic fibrosis (CF). CF-related diabetes (CFRD) is the most common complication of CF, and its presence increases morbidity and mortality in patients. Patients with CF (with and without CFRD) have potentially harmful glucose fluctuations and glucose excursions when compared to healthy adults. Carbohydrate intake and exercise have been shown to affect glycemia. Therefore, our hypothesis was that the proportion of energy from carbohydrates and total energy expenditure (TEE) would influence glucose fluctuations in adults with CF.
  
  
  METHODS
  A cross-sectional study involved 36 patients with CF, in whom continuous glucose monitoring systems were installed. Glucose fluctuations were then quantified using 3 indexes: mean amplitude of glucose excursions, standard deviation and coefficient of variation. Patients filled out a 3-day food diary to quantify energy intake and the proportions of calories from carbohydrates, fats and proteins, and they wore Sensewear Armbands to estimate spontaneous TEE and footsteps walked. Glucose tolerance status was determined using oral glucose tolerance tests.
  
  
  RESULTS
  Patients with CF with normal and impaired glucose tolerance had fewer glucose fluctuations than patients with CFRD (p<0.05). However, linear regression models used to determine whether nutrition or energy expenditure affects glucose fluctuations demonstrated that energy, the proportion of carbohydrates, of fat and of protein, TEE or the number of footsteps walked did not affect glucose fluctuation indexes (p>0.05).
  
  
  CONCLUSIONS
  TEE and the proportion of energy from carbohydrates did not affect glucose fluctuations in adults with CF.
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada; Nutrition Department, Pavillon Liliane-de-Stewart, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Ziai
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada; Nutrition Department, Pavillon Liliane-de-Stewart, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Adèle
authors.initials: A
authors.lastname: Coriati
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada.
authors.forename: David
authors.initials: D
authors.lastname: St-Pierre
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada; Nutrition Department, Pavillon Liliane-de-Stewart, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Chabot
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Desjardins
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada; Nutrition Department, Pavillon Liliane-de-Stewart, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Leroux
authors.affiliation: Department of Medicine, Étienne-Lebel Clinical Research Center, Sherbrooke, Québec, Canada.
authors.forename: Martin V
authors.initials: MV
authors.lastname: Richter
authors.affiliation: Institut de Recherches Cliniques de Montréal (IRCM), Montréal, Québec, Canada; Nutrition Department, Pavillon Liliane-de-Stewart, Université de Montréal, Montréal, Québec, Canada; Montreal Diabetes Research Centre (MDRC), Montréal, Québec, Canada; Cystic Fibrosis Clinic, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada. Electronic address: Remi.Rabasa-Lhoret@ircm.qc.ca.
authors.forename: Rémi
authors.initials: R
authors.lastname: Rabasa-Lhoret
mesh_terms: D000328:Adult; D001786:Blood Glucose; D050260:Carbohydrate Metabolism; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000209:etiology; D002149:Energy Intake; D004734:Energy Metabolism; D006801:Humans; D009752:Nutritional Status
chemical_list: D001786:Blood Glucose
keywords: cystic fibrosis-related diabetes; diabète associé à la fibrose kystique; dépense énergétique totale; fluctuations glycémiques; glucose fluctuations; pourcentage de l'apport énergétique provenant des glucides; proportion of energy from carbohydrates; total energy expenditure