P15 Use of continuous glucose monitoring in patients with cystic fibrosis related diabetes and with indeterminate curve of glucose tolerance. Preliminary results

Abstract

Introduction: Cystic fibrosis related diabetes (CFRD) is the most frequent associated disease in subjects with CF, it is accompanied by worse nutritional status, more severe inflammatory lung disease and higher mortality than individuals with type 1 or type 2 diabetes. Given that it is an important risk factor, early detection and timely treatment of CFRD improve the prognosis of these patients. Currently the diagnosis is made by fasting blood glucose, oral glucose tolerance test (OGTT) and / or HbA1c. Continuous flash glucose monitoring (CGM) has been validated and shown to be useful in patients with CFRD treated with insulin, to adjust the dose but not for diabetes diagnosis.

Objectives: to evaluate the clinical and biochemical characteristics of a cohort of CF patients with and without diabetes and to analyze the usefulness of CGM for early diagnosis and evolution assesment of CFRD.

Population, methods and procedures: an initial cross-section of a prospective study started in 2018 (preliminary results) is presented. Fifteen CF patients (9 with full evaluation) were studied in follow-up by the pulmonology department, older than 10 years with and without CFRD. Patients with an exacerbation were excluded. Clinical data (anthropometric, pulmonary function by spirometry, pubertal stage), biochemical data (blood glucose, PTOG and HbA1c) and interstitial glucose were obtained. The data were added to Excel spreadsheets and statistics were calculated with T and X2 tests. The degree of relationship between intersitial glucose, nutritional status, and lung function was analyzed using correlation and regression.

Results: Significant differences were found in nutritional status, lung function, glucose values obtained by CGM, HbA1c between CFRD and non-diabetic patients.

Conclusions: It is concluded that CGM is a useful tool for CFRD patients evolution assesment. It allows optimizing insulin and nutritional treatment, and a larger sample size is required to establish its usefulness for the diagnosis of CFRD.