• 作者：M. Martí ; n-Frí ; as^a ; ^{maria.martin.sg@hotmail.com} ; A. Lamas Ferreiro^b ; E. Colino Alcol^a ; M.A. Á ; lvarez Gó ; mez^a ; R. Yelmo Valverde^a ; R. Barrio Castellanos^a
• 关键词：Monitorizaci&oacute ; n continua de glucosa ; Alteraci&oacute ; n hidrocarbonada ; Cribado ; Fibrosis quí ; stica
• 刊名：Anales de Pediatr铆a
• 出版年：2009
• 期刊代码：pca47_16954033
• 类别：med
• 出版时间：February 2009
• 卷：70
• 期：2
• 页码：120-125
• 文件大小：759 K

Background

Diabetes mellitus (DM) is an increasing complication of cystic fibrosis (CF). It is associated with enhance morbidity. Continuous glucose monitoring system (CGMS) could detect glucose disorders earlier than other screening tests usually used.

Aims

To compare oral glucose tolerance test (OGTT), HbA_1c and CGMS in patients with CF and recent disorders of glucose homeostasis and to analyse changes in nutritional status and/or pulmonary function.

Patients and methods

Thirteen patients with CF (11鈥?2 years, 7 males) were studied using OGTT, HbA_1c and CGMS. All of them had newly diagnosed glucose disturbances. They were not receiving steroid therapy or had an underlying illness. In all subjects we compared: HbA_1c levels (%), fasting and 2-hours glucose OGTT (mg/dl) and glucose CGMS values (overall, fasting, 2-hours post mean-meals and excursions >140 mg/dl at any time). Furthermore, body mass index, forced expiratory volume in the first second (%) and forced vital capacity (%) were evaluated in the previous year and at the time of the study. We also analysed exocrine pancreatic function and CF-mutation.

Results

Mean age at diagnosis of glucose disturbance was 16.4 years. All patients had insufficient exocrine pancreatic function and 11/13 presented 螖F508 CF-mutation. Only one patient was diagnosed with DM using OGGT and 7/13 (53.8%) with CGMS. A total 77%of patients had poor nutritional status and/or pulmonary function at time of diagnosing the glucose disorder. Only 4 patients had abnormal HbA_1c levels.

Conclusions

CGMS allows a better detection of glucose disorders than OGTT. Glucose homeostasis abnormalities are associated with a decrease in nutritional status and/or pulmonary function. HbA_1c does not aid in the early diagnose of glucose disorders.