0926 CONTINUOUS GLUCOSE MONITORING, INSULIN RESISTANCE, AND SLEEP IN ADOLESCENTS WITH CYSTIC FIBROSIS

Abstract

Diabetes is diagnosed in one in four adolescents with cystic fibrosis (CF) and is associated with increased morbidity and mortality, thus there is a need to identify factors affecting glucose metabolism in CF. Patients with CF have greater objective and subjective sleep problems but the relationship between sleep and metabolic function has not been fully examined. The aim of the current study was to examine the relationship between objectively measured sleep and glucose metabolism in a sample of CF youth. Forty-three participants with CF at baseline health (mean age = 13.8 years) and 13 healthy controls (mean age = 15.2 years) underwent an oral glucose tolerance test (OGTT) and one week of concurrent home continuous glucose monitoring (CGM) and actigraphy. Fasting labs included glucose, insulin, and C-peptide. Two-sample independent t-tests and ANOVA tested differences between sleep outcomes in CF vs. control participants with post-hoc Tukey’s Honestly Significant Difference test. Spearman’s rank correlation coefficients tested correlations between sleep and CGM and insulin sensitivity. Of the CF participants, 15 had normal glycemia, 17 had abnormal glycemia, and 11 had CF-related diabetes (CFRD) per OGTT. Average sleep duration for the entire sample was 7.5 hours, indicating insufficient sleep. Participants with CF had longer sleep onset latency (SOL), lower sleep efficiency (SE), and higher wake after sleep onset (WASO) than controls. Higher minimum daytime glucoses on CGM correlated negatively with total sleep time and SE. In CF youth with abnormal glycemia or diabetes, poorer insulin sensitivity (lower 1/c-peptide) was seen in those with shorter sleep duration, longer SOL, poorer SE, and greater WASO. Poor sleep was correlated with higher glucose and lower insulin sensitivity in a sample of youth with CF. Further research is needed to better understand the mechanisms behind this relationship and potential implications for treatment and management of impaired glycemia in youth with CF. CFFT grant CHAN16A0 and NIH grants 5K12DK094712-04, UL1 TR001082 (CCTSI)