Insulin sensitivity, disposition index and insulin clearance in cystic fibrosis: a cross-sectional study

• Published in: Diabetologia 2024-10, Vol.67 (10), p.2188-2198
• Main Authors: Nielsen, Bibi U., Mathiesen, Inger H. M., Krogh-Madsen, Rikke, Katzenstein, Terese L., Pressler, Tacjana, Shaw, James A. M., Rickels, Michael R., Almdal, Thomas P., Faurholt-Jepsen, Daniel, Stefanovski, Darko
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Blood Glucose - metabolism; Cross-Sectional Studies; Cystic fibrosis; Cystic Fibrosis - blood; Cystic Fibrosis - metabolism; Diabetes mellitus; Exocrine Pancreatic Insufficiency - metabolism; Female; Glucose; Glucose Intolerance - blood; Glucose Intolerance - metabolism; Glucose tolerance; Glucose Tolerance Test; Human Physiology; Humans; Insulin; Insulin - blood; Insulin - metabolism; Insulin Resistance - physiology; Insulin secretion; Insulin Secretion - physiology; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Pancreas; Sensitivity analysis; Young Adult
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-024-06220-6

Aims/hypothesis The aim of this study was to investigate insulin secretion, insulin sensitivity, disposition index and insulin clearance by glucose tolerance status in individuals with cystic fibrosis (CF) and exocrine pancreatic insufficiency. Methods In a cross-sectional study, we conducted an extended (ten samples) OGTT in individuals with pancreatic-insufficient CF (PI-CF). Participants were divided into normal glucose tolerance (NGT), early glucose intolerance (EGI), impaired glucose tolerance (IGT) and CF-related diabetes (CFRD) groups. We used three different oral minimal models to assess insulin secretion, insulin sensitivity and insulin clearance during the OGTT. We evaluated insulin secretion using total secretion (Φ total), first-phase secretion (Φ dynamic) and second-phase secretion (Φ static) from the model, and we estimated the disposition index by multiplying Φ total and insulin sensitivity. Results Among 61 participants (NGT 21%, EGI 33%, IGT 16%, CFRD 30%), insulin secretion indices (Φ total, dynamic and static) were significantly lower in the CFRD group compared with the other groups. Insulin sensitivity declined with worsening in glucose tolerance ( p value for trend