Journal article
Glycemia and 8-cell function before and after elexacaftor/tezacaftor/ ivacaftor in youth and adults with cystic fibrosis
Journal of clinical & translational endocrinology, Vol.30, 100311
12/01/2022
DOI: 10.1016/j.jcte.2022.100311
PMCID: PMC9816065
PMID: 36620757
Abstract
Background: Diabetes is prevalent among people with CF (PwCF) and associated with worse clinical outcomes. CFTR modulators are highly effective in improving the disease course of CF. However, the effects of elexacaftor/ tezacaftor/ivacaftor (ETI) on glucose metabolism in PwCF are unclear.Methods: Twenty youth and adults with CF underwent frequently sampled oral glucose tolerance tests (fsOGTT) before and after ETI initiation. Glucose, insulin, and C-peptide were collected at 0, 10, 30, 60, 90, and 120 min after 1.75 g/kg (max 75 g) of dextrose. HbA1c and continuous glucose monitoring (CGM) were collected in a subset. Estimates of insulin secretion (C-peptide index), insulin resistance (HOMA2 IR and IS(OGTT Cpep)), and 8-cell function (C-peptide oral disposition index, oDIcoeo), were compared before and after ETI.Results: Participants were a median (IQR) of 20.4 (14.1, 28.6) years old, 75 % male. Follow-up occurred 10.5 (10.0, 12.3) months after ETI initiation. BMI z-score increased from 0.3 (-0.3, 0.8) to 0.8 (0.4, 1.5), p = 0.013 between visits. No significant differences were observed in glucose tolerance, glucose area under the curve, nor fsOGTT glucose concentrations before and after ETI. Median (IQR) C-peptide index increased from 5.7 (4.1, 8.3) to 8.8 (5.5, 10.8) p = 0.013 and HOMA2 IR increased (p < 0.001), while oDIcoeo was unchanged (p = 0.67). HbA1c decreased from 5.5 % (5.5, 5.8) to 5.4 % (5.2, 5.6) (p = 0.003) while CGM variables did not change.Conclusions: BMI z-score and measures of both insulin resistance and insulin secretion increased within the first year of ETI initiation. 8-cell function adjusted for insulin sensitivity (oDIcoeo) did not change.
Details
- Title: Subtitle
- Glycemia and 8-cell function before and after elexacaftor/tezacaftor/ ivacaftor in youth and adults with cystic fibrosis
- Creators
- Christine L. Chan - Children's Hospital ColoradoAndrea Granados - Nicklaus Childrens Hosp, Dept Pediat, Miami, FL USAAmir Moheet - University of MinnesotaSachinkumar Singh - University of IowaTimothy Vigers - University of Colorado Anschutz Medical CampusAna Maria Arbel - Washington Univ St Louis, Dept Pediat, St Louis, MO USAYaling Yi - Univ Iowa, Dept Anat & Cell Biol, Iowa City, IA USAShanming Hu - University of IowaAndrew W. Norris - University of IowaKatie Larson Ode - Univ Iowa, Stead Family Childrens Hosp, Dept Pediat, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Journal of clinical & translational endocrinology, Vol.30, 100311
- DOI
- 10.1016/j.jcte.2022.100311
- PMID
- 36620757
- PMCID
- PMC9816065
- NLM abbreviation
- J Clin Transl Endocrinol
- ISSN
- 2214-6237
- eISSN
- 2214-6237
- Publisher
- Elsevier
- Number of pages
- 7
- Grant note
- LAR-SON18A0; RC2-DK124207; R01-DK115791; 5 P30 DK054759-23 / Cystic Fibrosis Foundation; Italian Cystic Fibrosis Research Foundation
- Language
- English
- Date published
- 12/01/2022
- Academic Unit
- Endocrinology and Diabetes; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Biochemistry and Molecular Biology
- Record Identifier
- 9984378113502771
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