Taylor-Cousar J L, Janssen J S, Wilson A, Clair C G St, Pickard K M, Jones M C, Brayshaw S J, Chacon C S, Barboa C M, Sontag M K, Accurso F J, Nichols D P, Saavedra M T, Nick J A
Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA; Pediatrics, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
J Diabetes Res. 2016;2016:1527932. doi: 10.1155/2016/1527932. Epub 2016 Nov 24.
. 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. . 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. . 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. . There was a moderate correlation between interpreted results of 2-hour OGTT and CGM ( = 0.03); CGM indicated a greater level of glucose impairment than OGTT. Glucose >200 mg/dL by CGM predicted development of CFRD ( = 0.0002).
囊性纤维化相关糖尿病（CFRD）是囊性纤维化（CF）患者中最常见的合并症。尽管对CFRD的筛查、诊断和治疗有所增加，但CFRD患者的死亡率仍远高于非CFRD患者。指南建议每年使用2小时75克口服葡萄糖耐量试验（OGTT）对CFRD进行筛查。对推荐筛查的依从性较差，2014年只有约四分之一的成年CF患者接受了OGTT检查。使用持续葡萄糖监测（CGM）进行诊断可能成为一种替代方法。我们的目的是确定异常的CGM是否能预测成年CF患者随后发生CFRD、肺功能和体重指数（BMI）下降以及CF肺部加重率增加。在2009年9月至2010年9月进行的一项前瞻性单中心试点试验中，招募了21名应进行常规OGTT的成年患者，以同时完成3天的CGM和2小时75克OGTT。随后，回顾了2008年至2015年的临床信息。2小时OGTT和CGM的解释结果之间存在中度相关性（=0.03）；CGM显示的葡萄糖受损程度高于OGTT。CGM显示葡萄糖>200mg/dL可预测CFRD的发生（=0.0002）。
