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Abnormal Glucose Tolerance in Infants and Young Children with Cystic Fibrosis
Journal article   Open access   Peer reviewed

Abnormal Glucose Tolerance in Infants and Young Children with Cystic Fibrosis

Yaling Yi, Andrew W Norris, Kai Wang, Xingshen Sun, Aliye Uc, Antoinette Moran, John F Engelhardt and Katie Larson Ode
American journal of respiratory and critical care medicine, Vol.194(8), pp.974-980
10/15/2016
DOI: 10.1164/rccm.201512-2518OC
PMCID: PMC5067820
PMID: 27447840
url
https://doi.org/10.1164/rccm.201512-2518OCView
Published (Version of record) Open Access

Abstract

In cystic fibrosis, abnormal glucose tolerance is associated with decreased lung function and worsened outcomes. Translational evidence indicates that abnormal glucose tolerance may begin in early life. To determine whether very young children with cystic fibrosis have increased abnormal glucose tolerance prevalence compared with control subjects. The secondary objective was to compare area under the curve for glucose and insulin in children with cystic fibrosis with control subjects. This is a prospective multicenter study in children ages 3 months to 5 years with and without cystic fibrosis. Oral glucose tolerance testing with glucose, insulin, and C-peptide was sampled at 0, 10, 30, 60, 90, and 120 minutes. Twenty-three children with cystic fibrosis and nine control subjects had complete data. All control subjects had normal glucose tolerance. Nine of 23 subjects with cystic fibrosis had abnormal glucose tolerance (39%; P = 0.03). Of those, two met criteria for cystic fibrosis-related diabetes, two indeterminate glycemia, and six impaired glucose tolerance. Children with cystic fibrosis failed to exhibit the normal increase in area under the curve insulin with age observed in control subjects (P < 0.01), despite increased area under the curve glucose (P = 0.02). Abnormal glucose tolerance is notably prevalent among young children with cystic fibrosis. Children with cystic fibrosis lack the normal increase in insulin secretion that occurs in early childhood despite increased glucose. These findings demonstrate that glycemic abnormalities begin very early in cystic fibrosis, possibly because of insufficient insulin secretion.
Glucose Tolerance Test Prospective Studies Blood Glucose - analysis C-Peptide - blood Cystic Fibrosis - metabolism Humans Child, Preschool Female Infant Male Insulin - blood Case-Control Studies

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