P-225: Continuous glucose monitoring system for diagnosis of cystic fibrosis related diabetes in pediatric patients in Brazil
D Veloso Marinho Guedes, M Figueiredo Gonzaga de Lucena, A B Charantola Beloni, T Baldoni Auad Pereira, A L Lisbôa Prado, M Lenza, B Semer Kann, L Baldini Farjalla Mattar, L V Ribeiro ferreira, L Cominato, C Gouveia Buff PassoneAbstract
Introduction
Cystic fibrosis (CF) is an autosomal recessive disease due to a mutation in the CFTR gene causing dysfunction in the cystic fibrosis transmembrane regulatory protein (CFTR). Involvement of the exocrine pancreas can progress to cystic fibrosis-related diabetes (CFRD) in approximately 20% of adolescents and 30-50% of adults.
Objectives
To evaluate the glycemic profile through continuous glucose monitoring (CGM) with or without prior alteration of glycated hemoglobin (HbA1c) and/or oral glucose tolerance test (OGTT) and potential differences in the glycemic profile between patients with and without the use of the CFTR protein modulator.
Methods
Eighty-four patients between 6 and 18 years of age were selected and divided into groups with and without glycemic alterations according to Hb1Ac. A prospective, cross-sectional, single-center study was conducted to analyze the glycemic profile using CGM, HbA1c, and OGTT.
Results
Thirty-five patients were included in the study, divided into groups with HbA1c > 5.5% and < 5.5%. In the evaluation, the group with HbA1c ≥ 5.5% showed a higher percentage of time with blood glucose above 140 mg/dL compared to the group with HbA1c < 5.5% (p = 0.01). In 74.3% of participants, there was a peak above 200 mg/dL, with 55% of those in the HbA1c < 5.5% group experiencing this. In 21 of 35 patients, CFRD was diagnosed by CGM, with 50% of patients in the HbA1c < 5.5% group having this diagnosis.
Conclusions
Isolated HbA1c is not a good marker of early glycemic changes in CF, and the OGTT fails to identify some patients with dysglycemia. The CGM detected changes in patients considered normal by traditional methods, reinforcing its use as a complementary or even preferred tool in the early screening of CF-related diseases.