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Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response

Cystic fibrosis-related diabetes (CFRD) is a complication associated with a negative prognosis in patients with cystic fibrosis (CF). Although the oral glucose tolerance test (OGTT) is the widely recommended screening test for CFRD diagnosis, continuous glucose monitoring (CGM) is increasingly consi...

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Autores principales: Sebastian-Valles, Fernando, Arranz Martín, José Alfonso, Girón, Rosa María, Knott-Torcal, Carolina, Sampedro-Nuñez, Miguel Antonio, Martin-Adan, Jose Carlos, Jiménez-Díaz, Jessica, Marazuela, Mónica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296576/
https://www.ncbi.nlm.nih.gov/pubmed/37371849
http://dx.doi.org/10.3390/biomedicines11061754
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author Sebastian-Valles, Fernando
Arranz Martín, José Alfonso
Girón, Rosa María
Knott-Torcal, Carolina
Sampedro-Nuñez, Miguel Antonio
Martin-Adan, Jose Carlos
Jiménez-Díaz, Jessica
Marazuela, Mónica
author_facet Sebastian-Valles, Fernando
Arranz Martín, José Alfonso
Girón, Rosa María
Knott-Torcal, Carolina
Sampedro-Nuñez, Miguel Antonio
Martin-Adan, Jose Carlos
Jiménez-Díaz, Jessica
Marazuela, Mónica
author_sort Sebastian-Valles, Fernando
collection PubMed
description Cystic fibrosis-related diabetes (CFRD) is a complication associated with a negative prognosis in patients with cystic fibrosis (CF). Although the oral glucose tolerance test (OGTT) is the widely recommended screening test for CFRD diagnosis, continuous glucose monitoring (CGM) is increasingly considered a useful and easy-to-perform test for diagnosis and follow-up in clinical practice. Regarding CFRD treatment, although insulin is the classic approved pharmacological option, incretins could also be a helpful alternative in early stages. CGM could be also a useful tool to measure the early response to this therapy. METHODS: We studied 25 CF patients with abnormal OGTT results and compared glucose and insulin levels during the OGTTs with CGM results as a tool for early CFRD diagnosis. In addition, we evaluated glycaemic control with CGM before and after treatment with sitagliptin. RESULTS: A correlation was found between lower plasma insulin levels during the OGTTs and higher average sensor glucose (p = 0.009) and hyperglycaemic excursions (p = 0.017). The CGM data on sitagliptin treatment (n = 25) showed an average glycaemic improvement from 124.2 to 117.2 mg/dL (p = 0.002) with a 5.6-point standard deviation of glucose decrease (p < 0.001). Hyperglycaemic excursions ≥200 mg/dL diminished 57.1% (p = 0.021). Both time in range and time above 180 mg/dL improved during treatment (p = 0.036 and p = 0.006, respectively). CONCLUSION: CGM is a useful tool that offers valuable information for both the diagnosis and the management of CFRD. Lower plasma insulin levels during OGTTs are associated with a poor ambulatory glucose profile in CGM. Sitagliptin could play an important role in the treatment of the early stages of CFRD.
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spelling pubmed-102965762023-06-28 Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response Sebastian-Valles, Fernando Arranz Martín, José Alfonso Girón, Rosa María Knott-Torcal, Carolina Sampedro-Nuñez, Miguel Antonio Martin-Adan, Jose Carlos Jiménez-Díaz, Jessica Marazuela, Mónica Biomedicines Article Cystic fibrosis-related diabetes (CFRD) is a complication associated with a negative prognosis in patients with cystic fibrosis (CF). Although the oral glucose tolerance test (OGTT) is the widely recommended screening test for CFRD diagnosis, continuous glucose monitoring (CGM) is increasingly considered a useful and easy-to-perform test for diagnosis and follow-up in clinical practice. Regarding CFRD treatment, although insulin is the classic approved pharmacological option, incretins could also be a helpful alternative in early stages. CGM could be also a useful tool to measure the early response to this therapy. METHODS: We studied 25 CF patients with abnormal OGTT results and compared glucose and insulin levels during the OGTTs with CGM results as a tool for early CFRD diagnosis. In addition, we evaluated glycaemic control with CGM before and after treatment with sitagliptin. RESULTS: A correlation was found between lower plasma insulin levels during the OGTTs and higher average sensor glucose (p = 0.009) and hyperglycaemic excursions (p = 0.017). The CGM data on sitagliptin treatment (n = 25) showed an average glycaemic improvement from 124.2 to 117.2 mg/dL (p = 0.002) with a 5.6-point standard deviation of glucose decrease (p < 0.001). Hyperglycaemic excursions ≥200 mg/dL diminished 57.1% (p = 0.021). Both time in range and time above 180 mg/dL improved during treatment (p = 0.036 and p = 0.006, respectively). CONCLUSION: CGM is a useful tool that offers valuable information for both the diagnosis and the management of CFRD. Lower plasma insulin levels during OGTTs are associated with a poor ambulatory glucose profile in CGM. Sitagliptin could play an important role in the treatment of the early stages of CFRD. MDPI 2023-06-19 /pmc/articles/PMC10296576/ /pubmed/37371849 http://dx.doi.org/10.3390/biomedicines11061754 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sebastian-Valles, Fernando
Arranz Martín, José Alfonso
Girón, Rosa María
Knott-Torcal, Carolina
Sampedro-Nuñez, Miguel Antonio
Martin-Adan, Jose Carlos
Jiménez-Díaz, Jessica
Marazuela, Mónica
Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response
title Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response
title_full Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response
title_fullStr Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response
title_full_unstemmed Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response
title_short Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response
title_sort continuous glucose monitoring as an additional tool in early cystic fibrosis-related diabetes monitoring and in evaluation of short-term sitagliptin response
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296576/
https://www.ncbi.nlm.nih.gov/pubmed/37371849
http://dx.doi.org/10.3390/biomedicines11061754
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