Impaired glucose tolerance and indeterminate glycemia in cystic fibrosis

ABSTRACT: Highlights • Oral glucose tolerance testing is used for screening, diagnosis, and risk stratification of cystic fibrosis related diabetes.• Abnormal glucose tolerance in cystic fibrosis has prognostic utility with regards to progression towards overt diabetes, pulmonary function, weight loss, and mortality.• Further research is needed to delineate the significance of impaired glucose tolerance and indeterminate glycemia within the CF population.• Lower thresholds for indeterminate glycemia may be needed within the cystic fibrosis population. Oral glucose tolerance testing (OGTT) is the primary method to screen for and diagnose cystic fibrosis-related diabetes (CFRD). Diagnostic thresholds as currently defined are based on microvascular complications seen in type 2 diabetes. Abnormal glucose tolerance (AGT) refers to OGTT glucose elevations outside the normal range and encompasses both impaired and indeterminate glucose tolerance. Current guidelines define impaired glucose tolerance (IGT) as a 2-hour glucose of 140–199 mg/dL (7.8–11 mmol/L) and indeterminate glucose tolerance (INDET) as any mid-OGTT glucose ≥ 200 mg/dL (11.1 mmol/L) with a normal fasting and 2 h glucose. There is growing evidence that AGT also has associations with CF-centered outcomes including pulmonary decline, hospitalizations, and weight loss. Here we aim to review the historical emergence of glucose tolerance testing, review relevance to risk stratification for CFRD, discuss alternate cutoffs for identifying AGT earlier, and highlight the need for larger, future studies to inform our understanding of the implications of IGT and INDET on CF health.

SUBMITTER: Kasim N 

PROVIDER: S-EPMC8626567 | biostudies-literature |

REPOSITORIES: biostudies-literature