title: Abnormal Glucose Tolerance in Infants and Young Children with Cystic Fibrosis.
abstract: In cystic fibrosis, abnormal glucose tolerance is associated with decreased lung function and worsened outcomes. Translational evidence indicates that abnormal glucose tolerance may begin in early life.
  
  
  
  To determine whether very young children with cystic fibrosis have increased abnormal glucose tolerance prevalence compared with control subjects. The secondary objective was to compare area under the curve for glucose and insulin in children with cystic fibrosis with control subjects.
  
  
  
  This is a prospective multicenter study in children ages 3 months to 5 years with and without cystic fibrosis.
  
  
  
  Oral glucose tolerance testing with glucose, insulin, and C-peptide was sampled at 0, 10, 30, 60, 90, and 120 minutes. Twenty-three children with cystic fibrosis and nine control subjects had complete data. All control subjects had normal glucose tolerance. Nine of 23 subjects with cystic fibrosis had abnormal glucose tolerance (39%; P = 0.03). Of those, two met criteria for cystic fibrosis-related diabetes, two indeterminate glycemia, and six impaired glucose tolerance. Children with cystic fibrosis failed to exhibit the normal increase in area under the curve insulin with age observed in control subjects (P < 0.01), despite increased area under the curve glucose (P = 0.02).
  
  
  
  Abnormal glucose tolerance is notably prevalent among young children with cystic fibrosis. Children with cystic fibrosis lack the normal increase in insulin secretion that occurs in early childhood despite increased glucose. These findings demonstrate that glycemic abnormalities begin very early in cystic fibrosis, possibly because of insufficient insulin secretion.
authors.affiliation: 1 Department of Anatomy and Cell Biology.
authors.forename: Yaling
authors.initials: Y
authors.lastname: Yi
authors.affiliation: 2 Department of Pediatrics.|3 Fraternal Order of Eagles Diabetes Research Center, and.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Norris
authors.affiliation: 4 Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa; and.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: 1 Department of Anatomy and Cell Biology.
authors.forename: Xingshen
authors.initials: X
authors.lastname: Sun
authors.affiliation: 2 Department of Pediatrics.
authors.forename: Aliye
authors.initials: A
authors.lastname: Uc
authors.affiliation: 5 Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Moran
authors.affiliation: 1 Department of Anatomy and Cell Biology.|3 Fraternal Order of Eagles Diabetes Research Center, and.
authors.forename: John F
authors.initials: JF
authors.lastname: Engelhardt
authors.affiliation: 2 Department of Pediatrics.|3 Fraternal Order of Eagles Diabetes Research Center, and.
authors.forename: Katie Larson
authors.initials: KL
authors.lastname: Ode
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D016022:Case-Control Studies; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000378:metabolism*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007223:Infant; D007328:Insulin / Q000097:blood; D008297:Male; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin
keywords: abnormal glucose tolerance; children; cystic fibrosis; cystic fibrosis–related diabetes mellitus; infants