title: Glucose >200 mg/dL during Continuous Glucose Monitoring Identifies Adult Patients at Risk for Development of Cystic Fibrosis Related Diabetes.
abstract: Rationale. Cystic fibrosis related diabetes (CFRD) is the most common comorbidity in patients with CF. In spite of increased screening, diagnosis, and treatment of CFRD, the mortality rate in patients with CFRD still far exceeds the mortality rate in those without CFRD. Guidelines suggest that screening for CFRD be performed annually using the 2-hour 75-gram oral glucose tolerance test (OGTT). Adherence to recommended screening has been poor, with only approximately one-quarter of adults with CF undergoing OGTT in 2014. Use of continuous glucose monitoring (CGM) for diagnosis may become an alternative.Objectives. Our objective was to determine whether abnormal CGM predicts subsequent development of CFRD, lung function, and body mass index (BMI) decline and increased rate of CF pulmonary exacerbations in adults with CF.Methods. In a prospective single center pilot trial from September 2009 to September 2010, 21 adult patients due for routine OGTT were recruited to complete simultaneous 3-day CGM and 2-hour 75 gram OGTT. Subsequently, clinical information was reviewed from 2008 to 2015.Conclusions. There was a moderate correlation between interpreted results of 2-hour OGTT and CGM (p= 0.03); CGM indicated a greater level of glucose impairment than OGTT. Glucose >200 mg/dL by CGM predicted development of CFRD (p= 0.0002).
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: J L
authors.identifier: 0000-0002-5436-9722
authors.initials: JL
authors.lastname: Taylor-Cousar
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Janssen
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: A
authors.initials: A
authors.lastname: Wilson
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: C G St
authors.initials: CG
authors.lastname: Clair
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Pickard
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Jones
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Brayshaw
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Chacon
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Barboa
authors.affiliation: Colorado School of Public Health and University of Colorado, 13001 East 17th Place, Campus Box B119, Aurora, CO 80045, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Sontag
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, 13123 E 16th Ave, Aurora, CO 80045, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Accurso
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: D P
authors.initials: DP
authors.lastname: Nichols
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Saavedra
authors.affiliation: Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Nick
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D015897:Comorbidity; D003550:Cystic Fibrosis / Q000097:blood* / Q000150:complications*; D048909:Diabetes Complications / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000175:diagnosis; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose