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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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/6/1754 |
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| author | Fernando Sebastian-Valles José Alfonso Arranz Martín Rosa María Girón Carolina Knott-Torcal Miguel Antonio Sampedro-Nuñez Jose Carlos Martin-Adan Jessica Jiménez-Díaz Mónica Marazuela |
| author_facet | Fernando Sebastian-Valles José Alfonso Arranz Martín Rosa María Girón Carolina Knott-Torcal Miguel Antonio Sampedro-Nuñez Jose Carlos Martin-Adan Jessica Jiménez-Díaz Mónica Marazuela |
| author_sort | Fernando Sebastian-Valles |
| collection | DOAJ |
| 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 (<i>p</i> = 0.009) and hyperglycaemic excursions (<i>p</i> = 0.017). The CGM data on sitagliptin treatment (<i>n</i> = 25) showed an average glycaemic improvement from 124.2 to 117.2 mg/dL (<i>p</i> = 0.002) with a 5.6-point standard deviation of glucose decrease (<i>p</i> < 0.001). Hyperglycaemic excursions ≥200 mg/dL diminished 57.1% (<i>p</i> = 0.021). Both time in range and time above 180 mg/dL improved during treatment (<i>p</i> = 0.036 and <i>p</i> = 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. |
| first_indexed | 2024-03-11T02:44:17Z |
| format | Article |
| id | doaj.art-f328da5d2daf4995956136a06a2e9d35 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T02:44:17Z |
| publishDate | 2023-06-01 |
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| series | Biomedicines |
| spelling | doaj.art-f328da5d2daf4995956136a06a2e9d352023-11-18T09:27:42ZengMDPI AGBiomedicines2227-90592023-06-01116175410.3390/biomedicines11061754Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin ResponseFernando Sebastian-Valles0José Alfonso Arranz Martín1Rosa María Girón2Carolina Knott-Torcal3Miguel Antonio Sampedro-Nuñez4Jose Carlos Martin-Adan5Jessica Jiménez-Díaz6Mónica Marazuela7Department of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Pneumology, Hospital Universitario la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainDepartment of Endocrinology and Nutrition, Hospital Universitario de la Princesa, IIS-Princesa, Universidad Autónoma de Madrid (UAM), 28006 Madrid, SpainCystic 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 (<i>p</i> = 0.009) and hyperglycaemic excursions (<i>p</i> = 0.017). The CGM data on sitagliptin treatment (<i>n</i> = 25) showed an average glycaemic improvement from 124.2 to 117.2 mg/dL (<i>p</i> = 0.002) with a 5.6-point standard deviation of glucose decrease (<i>p</i> < 0.001). Hyperglycaemic excursions ≥200 mg/dL diminished 57.1% (<i>p</i> = 0.021). Both time in range and time above 180 mg/dL improved during treatment (<i>p</i> = 0.036 and <i>p</i> = 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.https://www.mdpi.com/2227-9059/11/6/1754CFRDCGMdiabetesgliptinsprediabetesbeta cell |
| spellingShingle | Fernando Sebastian-Valles José Alfonso Arranz Martín Rosa María Girón Carolina Knott-Torcal Miguel Antonio Sampedro-Nuñez Jose Carlos Martin-Adan Jessica Jiménez-Díaz Mónica Marazuela Continuous Glucose Monitoring as an Additional Tool in Early Cystic Fibrosis-Related Diabetes Monitoring and in Evaluation of Short-Term Sitagliptin Response Biomedicines CFRD CGM diabetes gliptins prediabetes beta cell |
| 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 | CFRD CGM diabetes gliptins prediabetes beta cell |
| url | https://www.mdpi.com/2227-9059/11/6/1754 |
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