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Acute hyperglycaemia in cystic fibrosis pulmonary exacerbations

Lina Merjaneh1,2, Demet Toprak2,3, Sharon McNamara3

  • 1Division of Endocrinology and Diabetes, Seattle Children's Hospital, Seattle, WA, USA.

Endocrinology, Diabetes & Metabolism
|April 15, 2021
PubMed

Insights

Hyperglycaemia is common in pediatric cystic fibrosis (CF) patients during pulmonary exacerbations. While it improves with treatment, it may worsen later due to reduced insulin secretion.

Area of Science:

  • Pediatric Endocrinology
  • Pulmonology
  • Metabolic Disorders

Background:

  • Pulmonary exacerbations in cystic fibrosis (CF) are linked to poor recovery.
  • Hyperglycaemia (high blood sugar) is a potential contributing factor to recovery failure in CF patients.

Purpose of the Study:

  • To determine the prevalence of hyperglycaemia in pediatric CF patients during and after pulmonary exacerbations.
  • To investigate the underlying mechanisms of hyperglycaemia in this context.

Main Methods:

  • Nine pediatric CF patients not on insulin therapy were studied.
  • Oral glucose tolerance tests (OGTT) and continuous glucose monitoring (CGM) were performed during exacerbation (visit 1), 2 weeks post-exacerbation (visit 2), and 6 weeks to 12 months later (visit 3).
  • Insulin and glucose levels were measured, and hyperglycaemia was defined by American Diabetes Association criteria and CGM data.

Main Results:

  • 8/9 patients exhibited hyperglycaemia during exacerbation (visit 1), with 2 diagnosed with diabetes and 6 with abnormal OGTT.
  • Hyperglycaemia persisted at 2 weeks (5/8 patients) and 6 weeks to 12 months post-exacerbation (5/7 patients).
  • Insulin secretion, measured by AUC, decreased significantly from visit 2 to visit 3.

Conclusions:

  • Hyperglycaemia is highly prevalent in pediatric CF patients experiencing exacerbations.
  • While hyperglycaemia may temporarily improve with exacerbation treatment, it tends to worsen later, associated with diminished insulin secretion.
  • These findings highlight the importance of monitoring glucose metabolism in CF patients during and after exacerbations.
Abstract

Keywords:
continuous glucose monitoringcystic fibrosis‐related diabeteshyperglycaemiainsulinoral glucose tolerance test

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