Applicability of continuous glucose monitoring to screen for cystic
fibrosis-related diabetes onset and clinical impairment
Abstract
Background and Objectives: Cystic fibrosis-related diabetes is the major
comorbidity in cystic fibrosis and reduces life expectancy, highlighting
the need for early diagnosis and treatment. This study aimed to verify
whether abnormal continuous glucose monitoring results predict cystic
fibrosis-related diabetes onset and/or a decline in the forced
expiratory volume in the 1st second or body mass index of patients with
cystic fibrosis. Methods: Thirty-nine patients with cystic fibrosis (age
10–19 years) were screened for cystic fibrosis-related diabetes using
the oral glucose tolerance test. Patients without diabetes diagnose
underwent 3 days of continuous glucose monitoring, spirometry and body
mass index measurements and were reassessed at the end of the study with
a second spirometry, body mass index evaluation and oral glucose
tolerance test. Results: Thirty-four patients completed the follow-up
(3.1±0.51 years). None of the study variables predicted cystic
fibrosis-related diabetes progression or were associated with
hypoglycemic events. Continuous glucose monitoring could detect glucose
abnormalities not revealed in the oral glucose tolerance test. Patients
with glucose level of >140 mg/dL on continuous glucose
monitoring showed significantly lower body mass index z scores at both
study initiation (-1.55±1.68 vs. -0.17±0.88; p-value=0.02) and
completion (-1.65±1.55 vs. -0.42±1.08; p-value=0.039). Conclusions:
Continuous glucose monitoring can identify glucose abnormalities not
detected by oral glucose tolerance test that are related to early stage
decreases in body mass index. However, it was ineffective in predicting
the onset of diabetes in this cystic fibrosis population. Different
diagnostic criteria for diabetes may be required for individuals with
cystic fibrosis.