Early glucose abnormalities are associated with pulmonary inflammation in young children with cystic fibrosis

Children with CF are insulin deficient from infancy but very little is known about the impact of glucose abnormalities in early life. We aimed to identify and describe interstitial glucose levels in CF children 11.1 mmol/L in 39% of participants. The percentage neutrophil count on BAL was positively...

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Bibliographic Details
Published in:Journal of cystic fibrosis 2019-11, Vol.18 (6), p.869-873
Main Authors: Prentice, Bernadette J., Ooi, Chee Y., Strachan, Roxanne E., Hameed, Shihab, Ebrahimkhani, Saeideh, Waters, Shafagh A., Verge, Charles F., Widger, John
Format: Article
Language:English
Subjects:
CGM
Continuous glucose monitoring
Cystic fibrosis
Cystic fibrosis-related diabetes
Inflammation
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Summary:Children with CF are insulin deficient from infancy but very little is known about the impact of glucose abnormalities in early life. We aimed to identify and describe interstitial glucose levels in CF children 11.1 mmol/L in 39% of participants. The percentage neutrophil count on BAL was positively correlated with elevated SG (peak SG rs = 0.48, p = .044) and with glucose variability (SG standard deviation r = 0.62, β = 38.5, p = .006). BAL IL-8 level was significantly correlated with all measures of CGM hyperglycemia including % time > 7.8 mmol/L (p = .008) and standard deviation (p  7.8 mmol/L glucose (16% versus 3%, p = .015). Children with CF frequently demonstrate elevated SG levels before age 6 years, which are associated with increased pulmonary inflammation and Pseudomonas aeruginosa infection. Transient SG elevations into the diabetic range (≥11.1 mmol/L) were identified in children from 1 year of age. •Children with CF may have diabetic range  glucose levels detected by CGM from as early as 1 year of age.•Peak glucose on CGM is correlated with inflammation on bronchoalveolar lavage•Children with a past history of Pseudomonas aeruginosa spend more time in the impaired glucose range (>7.8 mmol/L).
ISSN:1569-1993
1873-5010
DOI:10.1016/j.jcf.2019.03.010