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Oral glucose tolerance testing in children with cystic fibrosis
Journal article   Open access   Peer reviewed

Oral glucose tolerance testing in children with cystic fibrosis

Katie Larson Ode, Brigitte Frohnert, Theresa Laguna, James Phillips, Bonnie Holme, Warren Regelmann, William Thomas and Antoinette Moran
Pediatric diabetes, Vol.11(7), pp.487-492
Submitted 24 July 2009. Accepted for publication 24 November 2009
11/2010
DOI: 10.1111/j.1399-5448.2009.00632.x
PMCID: PMC3856892
PMID: 20202149
url
https://doi.org/10.1111/j.1399-5448.2009.00632.xView
Published (Version of record) Open Access

Abstract

Background: Cystic fibrosis (CF) related diabetes is the most common comorbidity in persons with CF. International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines recommend annual oral glucose tolerance testing (OGTT) screening starting at age 10. The OGTT might be recommended in younger children if, as in adults, it provided clinically relevant prognostic information. A database review was performed to determine whether OGTT findings in children with CF predict subsequent clinical course. Methods: A retrospective matched-pair cohort study was based on OGTTs performed during 1998-2003. Children aged 6-9 were classified as having normal glucose tolerance (NGT) or abnormal glucose tolerance (AGT). Children with AGT were matched by age and gender to those with NGT. Clinical status was assessed at baseline and 5 yr later. In a separate investigation, diabetes and prior AGT status of children aged 10-18 were used to assess predictions derived from the cohort study. Results: In 1998-2003, 39 of 94 children had AGT. Of these, 31 had sufficient follow-up data to be included. Both at baseline and 5 yr later there was no significant difference in height, weight, body mass index (BMI) or lung function between AGT and NGT. Diabetes developed in 13 AGT (42%) and one NGT (3%) [odds ratio (OR) 11, p = 0.0009]. Age of diabetes onset was 12 ± 1 yr in boys and 11 ± 1 yr in girls, compared to approximately 23 yr in the general CF population. Fifteen current children age 10-18 who had AGT before age 10 have diabetes, close to the prediction of 19. Conclusions: AGT in children with CF age 6-9 yr identifies those at high risk for progression to early onset diabetes.
prognosis CFRD

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