Abnormal Glucose Tolerance in Infants and Young Children with Cystic Fibrosis

• Published in: American journal of respiratory and critical care medicine 2016-10, Vol.194 (8), p.974-980
• Main Authors: Yi, Yaling, Norris, Andrew W, Wang, Kai, Sun, Xingshen, Uc, Aliye, Moran, Antoinette, Engelhardt, John F, Ode, Katie Larson
• Format: Article
• Language: English
• Subjects: Blood Glucose - analysis; C-Peptide - blood; Case-Control Studies; Child, Preschool; Cystic Fibrosis - metabolism; Female; Glucose Tolerance Test; Humans; Infant; Insulin - blood; Male; Original; Prospective Studies
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.201512-2518OC

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