The features of carbohydrate metabolism in children with cystic fi brosis: a 30-year-long history

Abstract

Th e article presents a review on a cystic fibrosis-r elated diabetes, a severe complication of cystic fi brosis in children, which has acquired increasing importance and revealed to contribute in prognosis of the disease in recent years. Which include resent and historical epidemiology, pathophysiology, diagnostic methods, features of the course and the latest aspects of the targeted therapy effect on endocrine function of the pancreas. The authors presented a retrospective analysis of the carbohydrate metabolism condition in two groups of children with cystic fi brosis investigated in 1993 and 2021. These groups diff ered signifi cantly in baseline enzyme therapy, diet and nutritional support (the intake of supplementary medical nutrition). The study confi rmed that present-day patients have a lower percentage of impaired carbohydrate metabolism on the background of complete therapy. The authors proved that carbohydrate metabolism disorders occur earlier in nowadays children with cystic fi brosis, at the age before 10 years. This fi nding provides strong evidence that prediabetes is a period they should be diagnosed. These changes can be identifi ed only by a complete examination of the glycemic profi le of the patient, rather than, as previously thought, an oral glucose tolerance test. The study identifi ed that the indicator of continuous glucose monitoring — 6.42 mmol/l could be a predictor of the possible transition of prediabetic stage into cystic fi brosis related diabetes. The obtained results are confi rmed by the clinical case given by the authors.