Continuous glucose monitoring guided insulin therapy is associated with improved clinical outcomes in cystic fibrosis-related diabetes



Frost, Freddy ORCID: 0000-0002-3902-6502, Dyce, Paula, Nazareth, Dilip ORCID: 0000-0002-6114-0467, Malone, Victoria and Walshaw, Martin J
(2018) Continuous glucose monitoring guided insulin therapy is associated with improved clinical outcomes in cystic fibrosis-related diabetes. JOURNAL OF CYSTIC FIBROSIS, 17 (6). pp. 798-803.

This is the latest version of this item.

[img] Text
CGM_JCF_Re-submission2_Clean.pdf - Author Accepted Manuscript

Download (908kB)

Abstract

<h4>Introduction</h4>Continuous glucose monitoring (CGM) allows assessment of day to day glycaemic excursions and detects early glucose handling abnormalities that may not be apparent on oral glucose tolerance testing (OGTT). However, there is little published evidence as to whether these early dysglycaemic changes are amenable to treatment. We present outcomes following CGM guided insulin initiation at our centre.<h4>Methods</h4>Adults without a prior diagnosis of cystic fibrosis related diabetes (CFRD) whom underwent >72 h CGM at our adult CF centre were included in the study. Clinical outcomes including weight and pulmonary function changes over the next 12 months were compared between groups based on CGM results and subsequent management.<h4>Results</h4>CGM profiles for 59 patients were analysed. Insulin was commenced in 37 patients who had evidence of hyperglycaemia on CGM. Significant improvements in mean [95% confidence intervals] forced expiratory volume in 1 s (FEV<sub>1</sub>) (+4.3% predicted [1.06-7.48], p = 0.01) and weight (+1.2 kg [0.32-2.15], p = 0.01) were observed at 3 months in the insulin group. Annual rate of pulmonary function decline was also improved following insulin initiation.<h4>Conclusion</h4>Insulin treatment targeted towards glycaemic excursions seen on CGM is associated with improvements in lung function and weight with subsequent reduced pulmonary function decline.

Item Type: Article
Uncontrolled Keywords: Humans, Cystic Fibrosis, Diabetes Mellitus, Body Weight, Insulin, Hypoglycemic Agents, Glucose Tolerance Test, Respiratory Function Tests, Drug Monitoring, Treatment Outcome, Adult, Female, Male, Medication Therapy Management, United Kingdom, Correlation of Data
Depositing User: Symplectic Admin
Date Deposited: 29 Jun 2018 09:21
Last Modified: 19 Jan 2023 01:31
DOI: 10.1016/j.jcf.2018.05.005
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3023131

Available Versions of this Item