Clemente León María, Bilbao Gassó Laura, Moreno-Galdó Antonio, Campos Martorrell Ariadna, Gartner Tizzano Silvia, Yeste Fernández Diego, Carrascosa Lezcano Antonio
Unidad de Endocrinología, Servicio de Pediatría, Hospital Vall d'Hebron, Grupo de Investigación Crecimiento y Desarrollo, Instituto Investigación Vall d'Hebron (VHIR), CIBER de Enfermedades Raras, Instituto Salud Carlos III, Universitat Autònoma de Barcelona, Spain.
Unidad de Endocrinología, Servicio de Pediatría, Hospital Vall d'Hebron, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2018 Jan;65(1):45-51. doi: 10.1016/j.endinu.2017.08.008. Epub 2017 Nov 12.
Patients with cystic fibrosis (CF) undergo a slow and progressive process toward diabetes. Oral glucose tolerance test (OGTT) is recommended to diagnose impaired glucose levels in these patients. Continuous glucose monitoring (CGM) measures glucose profiles under real-life conditions.
To compare OGTT and CGM results in CF patients.
Paired OGTT and 6-day CGM profiles (146.2±9.1h/patient) were performed in 30 CF patients aged 10-18 years.
According to OGTT, 14 patients had normal glucose tolerance (NGT), 14 abnormal glucose tolerance (AGT), and two cystic fibrosis-related diabetes (CFRD). In 27 patients (13 NGT, 13 AGT, 1 CFRD), CGM showed glucose values ranging from 140 to 200mg/dL during similar monitoring times (2%-14% with NGT, 1%-16.9% with AGT, and 3% with CFRD). Glucose peak levels ≥200mg/dL were seen in seven patients (3 NGT, 3 AGT, 1 CFRD). According to CGM, two patients had all glucose values under 140mg/dL (1 NGT, 1 AGT). Seventeen patients had glucose levels ranging from 140 to 200mg/dL (10 NGT, 6 AGT, 1 CFRD). Ten patients (3 NGT, 7 AGT) had glucose values ≥200mg/dL for ≤1% of the monitoring time and one (CFRD) for >1% of the monitoring time.
OGTT results did not agree with those of the CGM. CGM allows for diagnosis of glucose changes not detected by OGTT. Such changes may contribute to optimize pre-diabetes management in CF patients.
囊性纤维化(CF)患者会经历一个缓慢且渐进性的糖尿病发展过程。建议采用口服葡萄糖耐量试验(OGTT)来诊断这些患者的血糖水平受损情况。持续葡萄糖监测(CGM)可在实际生活条件下测量血糖曲线。
比较CF患者的OGTT和CGM结果。
对30名年龄在10至18岁的CF患者进行了配对的OGTT和为期6天的CGM监测(每位患者146.2±9.1小时)。
根据OGTT结果,14名患者葡萄糖耐量正常(NGT),14名患者葡萄糖耐量异常(AGT),2名患者患有囊性纤维化相关糖尿病(CFRD)。在27名患者(13名NGT、13名AGT、1名CFRD)中,CGM显示在相似的监测时间内血糖值范围为140至200mg/dL(NGT患者为2% - 14%,AGT患者为1% - 16.9%,CFRD患者为3%)。7名患者(3名NGT、3名AGT、1名CFRD)出现血糖峰值水平≥200mg/dL。根据CGM结果,2名患者所有血糖值均低于140mg/dL(1名NGT、1名AGT)。17名患者血糖水平范围为140至200mg/dL(10名NGT、6名AGT、1名CFRD)。10名患者(3名NGT、7名AGT)血糖值≥200mg/dL的监测时间≤1%,1名患者(CFRD)血糖值≥200mg/dL的监测时间>1%。
OGTT结果与CGM结果不一致。CGM能够诊断出OGTT未检测到的血糖变化。这些变化可能有助于优化CF患者的糖尿病前期管理。