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Feasibility of Using Continuous Glucose Monitoring to Detect Glycemic Abnormalities in Children with Cystic Fibrosis
Amanda Leonard1, Isabel R Judware2, Lori L Vanscoy3
1Division of Pediatric Nutrition, Johns Hopkins Hospital, Baltimore, Maryland, USA, amleonar@jhmi.edu.
Insights
Continuous glucose monitoring (CGM) is a feasible method for detecting glucose abnormalities in children with cystic fibrosis (CF). This approach aids in the early recognition of cystic fibrosis-related diabetes (CFRD), improving patient outcomes.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Respiratory Medicine
Background:
- Cystic fibrosis-related diabetes (CFRD) significantly worsens pulmonary function and increases mortality in cystic fibrosis (CF) patients.
- Early detection of CFRD is crucial for managing CF progression.
- Current oral glucose tolerance tests (OGTT) pose challenges in busy clinical settings.
Purpose of the Study:
- To evaluate the feasibility of continuous glucose monitoring (CGM) for detecting glucose abnormalities in pediatric CF patients.
- To assess CGM as an alternative for patients unable to complete an OGTT or requiring further data.
Main Methods:
- A 10-day CGM (Dexcom G6Pro) session was implemented in a pediatric CF clinic.
- Participants included patients who could not undergo an OGTT or had abnormal OGTT results.
- Data from returned CGM sensors were analyzed.
Main Results:
- High return rate (94%) and adherence (median 10 days wear) for CGM sensors.
- A significant proportion (59%) of returned CGMs indicated glucose abnormalities requiring referral.
- CGM successfully gathered data for treatment decisions.
Conclusions:
- Continuous glucose monitoring (CGM) is a practical and feasible tool for identifying glucose abnormalities in children with CF.
- CGM facilitates early detection of CFRD in pediatric CF clinics.
- This method supports timely clinical decisions for managing glucose metabolism in CF patients.
Introduction:
Cystic fibrosis-related diabetes (CFRD) is linked to worsening pulmonary function and increased mortality in people with cystic fibrosis (CF). Because of this correlation, early recognition of CFRD is important. Current recommendations for detecting glucose abnormalities using an oral glucose tolerance test (OGTT) can be difficult to achieve in a busy clinical setting.
Methods:
We trialed a 10-day continuous glucose monitoring (CGM) (Dexcom G6Pro) session in patients seen in our pediatric CF clinic that could not do an OGTT (reasons include emesis with OGTT or fear of needles) or that had an abnormal OGTT (to gather additional data to make treatment decisions).
Results:
Of the 36 sensors placed, 34 (94%) were returned. Devices were worn for a median of 10 days (range 4-10 days). Of the 34 CGMs returned, 20 (59%) met the criterion for referral to a pediatric endocrinologist.
Conclusion:
CGM placement is feasible in a busy CF clinic to detect glucose abnormalities in children.
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