Impaired Glucose Tolerance and Diabetes in Patients with Cystic Fibrosis
Výskyt porušené glukózové tolerance a diabetu u pacientůs cystickou fibrózou
Porušená glukózová tolerance a diabetes mellitus (CFRD - cystic fibrosis related diabetes) jsou častou komplikacíu pacientů s cystickou fibrózou. V rámci screeningu CFRD autoři u 122 pacientů starších 10 let, bez klinickésymptomatologie diabetes mellitus, vyšetřili orální glukózový toleranční test (oGTT). U jedinců s patologickýmoGTT byl následně proveden intravenózní glukózový toleranční test ke zjištění stimulované inzulinové sekrece(FPIR; součet hladin inzulinu v 1. a 3. minutě po i.v. bolusu glukózy). CFRD byl diagnostikován u 19/122 pacientů(15,6 %), porušená glukózová tolerance (PGT) byla zjištěna u 18/122 jedinců (14,8 %). Celkem bylo diagnostikováno37/122 pacientů (30,3 %) s PGT či CFRD. Výrazná inzulinopenie (FPIR < 48 mIU/l) byla nalezenacelkem u 29/122 nemocných (23,8 %), z toho u 10/18 s porušenou glukózovou tolerancí. Nález výrazné inzulinopeniei u pacientů s PGT umožňuje racionálně volit individuální terapeutické postupy.
Klíčová slova:
cystická fibróza, diabetes mellitus, CFRD, porušená glukózová tolerance, FPIR
Authors:
S. Koloušková; D. Zemková; J. Bartošová; Z. Šumník; V. Vávrová
Authors‘ workplace:
II. dětská klinika 2. LF UK a FN Motol, Prahapřednosta doc. MUDr. J. Vavřinec, DrSc.
Published in:
Čes-slov Pediat 2003; (5): 270-273.
Category:
Overview
Impaired glucose tolerance and diabetes mellitus (CFRD - cystic fibrosis related diabetes) are a frequentcomplication in patients with cystic fibrosis. Within the framework of CFRD screening the authors examined in122 patients above the age of 10 years without clinical symptoms of diabetes mellitus the oral glucose tolerance test(oGTT). In subjects with a pathological oGTT subsequently the intravenous glucose tolerance test was made toassess stimulated insulin secretion (FPIR; sum of insulin levels during the 1st and 3rd minute after an i.v. glucosebolus). CFRD was diagnosed in 19/122 patients (15.6%), impaired glucose tolerance in 18/122 (14.8%). A total of37/122 (30.3%) patients with impaired glucose tolerance or CFRD were diagnosed. Marked insulinopenia (FPIR< 48 mIU/l) was found in a total of 29/122 patients (23.8%), incl. 10/18 with impaired glucose tolerance. The findingof marked insulinopenia makes it possible also in patients with impaired glucose tolerance to select rationallyindividual therapeutic procedures.
Key words:
cystic fibrosis, diabetes mellitus, CFRD, impaired glucose tolerance, FPIR
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
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