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Insulin secretion abnormalities in exocrine pancreatic sufficient cystic fibrosis patients

Jamie L Wooldridge1, Rhonda D Szczesniak2, Matthew C Fenchel2

  • 1Department of Pediatrics, St. Louis University School of Medicine, St. Louis, MO 63104, United States.

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|March 11, 2015
PubMed

Insights

Pediatric cystic fibrosis (CF) patients, even those with sufficient pancreatic function, exhibit reduced insulin secretion. This impaired insulin response may increase the risk of glucose intolerance and warrants regular screening for CF-related diabetes (CFRD).

Area of Science:

  • Endocrinology
  • Pediatrics
  • Metabolic Disorders

Background:

  • Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs.
  • Insulin secretion abnormalities are increasingly recognized in CF patients.
  • Exocrine pancreatic insufficiency is common in CF, but its impact on insulin secretion needs further clarification.

Purpose of the Study:

  • To evaluate insulin secretion during an oral glucose tolerance test (OGTT) in pediatric patients with cystic fibrosis.
  • To compare insulin secretion between CF patients with exocrine pancreatic sufficiency (CF-PS) and insufficiency (CF-PI).
  • To assess the relationship between body mass index (BMI) and insulin response in CF patients.

Main Methods:

  • 146 pediatric CF patients underwent an OGTT to measure glucose and insulin levels.
  • Patients were categorized into CF-PS and CF-PI groups based on clinical criteria.
  • A control group of healthy, non-diabetic subjects was included for comparison.

Main Results:

  • All CF patient groups demonstrated a reduced insulinogenic index, indicating impaired insulin secretion.
  • CF-PS patients maintained normal glucose tolerance despite reduced insulin secretion.
  • A positive correlation was observed between BMI z-score and the insulin area under the curve.

Conclusions:

  • Reduced insulin secretion is a characteristic finding in pediatric CF patients, irrespective of exocrine pancreatic status.
  • Impaired insulin secretion may predispose CF patients to glucose intolerance, especially under conditions of inflammation or nutritional stress.
  • All individuals with CF should adhere to CF-related diabetes (CFRD) screening protocols due to the universal risk of abnormal insulin secretion.
Abstract

Keywords:
AnabolismHyperglycemiaInsulin deficiencyInsulin-secreting cellsPancreatic cystic fibrosis

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