Validation of continuous glucose monitoring in children and adolescents with cystic fibrosis: a prospective cohort study

Stephen M P O'Riordan, Peter Hindmarsh, Nathan R Hill, David R Matthews, Sherly George, Peter Greally, Gerard Canny, Dubhfeasa Slattery, Nuala Murphy, Edna Roche, Colm Costigan, Hilary Hoey, Stephen M P O'Riordan, Peter Hindmarsh, Nathan R Hill, David R Matthews, Sherly George, Peter Greally, Gerard Canny, Dubhfeasa Slattery, Nuala Murphy, Edna Roche, Colm Costigan, Hilary Hoey

Abstract

Objective: To validate continuous glucose monitoring (CGM) in children and adolescents with cystic fibrosis.

Research design and methods: Paired oral glucose tolerance tests (OGTTs) and CGM monitoring was undertaken in 102 children and adolescents with cystic fibrosis (age 9.5-19.0 years) at baseline (CGM1) and after 12 months (CGM2). CGM validity was assessed by reliability, reproducibility, and repeatability.

Results: CGM was reliable with a Bland-Altman agreement between CGM and OGTT of 0.81 mmol/l (95% CI for bias +/- 2.90 mmol/l) and good correlation between the two (r = 0.74-0.9; P < 0.01). CGM was reproducible with no significant differences in the coefficient of variation of the CGM assessment between visits and repeatable with a mean difference between CGM1 and CGM2 of 0.09 mmol/l (95% CI for difference +/- 0.46 mmol/l) and a discriminant ratio of 13.0 and 15.1, respectively.

Conclusions: In this cohort of children and adolescents with cystic fibrosis, CGM performed on two occasions over a 12-month period was reliable, reproducible, and repeatable.

References

    1. Moran A: Diagnosis, screening, and management of cystic fibrosis-related diabetes. Curr Diab Rep 2002; 2: 111– 115
    1. Lanng ST, Nerup B, Koch JC: Influence of the development of diabetes mellitus on clinical status in patients with cystic fibrosis. Eur J Pediatr 1992; 151: 684– 687
    1. Finkelstein SM, Wielinski CL, Elliott GR, Warwick WJ, Barbosa J, Wu SC, Klein DJ: Diabetes mellitus associated with cystic fibrosis. J Pediatr 1988; 112: 373– 377
    1. Lanng S, Thorsteinsson B, Nerup J, Koch C: Diabetes mellitus in cystic fibrosis: effect of insulin therapy on lung function and infections. Acta Paediatr 1994; 83: 849– 853
    1. Dobson L, Hattersley AT, Tiley S, Elworthy S, Oades PJ, Sheldon CD: Clinical improvement in cystic fibrosis with early insulin treatment. Arch Dis Child 2002; 87: 430– 431
    1. Dobson L, Sheldon CD, Hattersley AT: Conventional measures underestimate glycaemia in cystic fibrosis patients. Diabet Med 2004; 21: 691– 696
    1. Dobson L, Sheldon CD, Hattersley AT: Validation of interstitial fluid continuous glucose monitoring in cystic fibrosis. Diabetes Care 2003; 26: 1940– 1941
    1. World Health Organization: Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complications Part 1: Diagnosis and Classification of Diabetes Mellitus.WHO/NCD/NCS/99.2, 1999. Diagnostic Criteria for Diabetes Mellitus, Geneva, World Health Organization, 1999
    1. Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307– 310
    1. Bland JM, Altman DJ: Regression analysis. Lancet 1986; 1: 908– 909
    1. Levy J, Morris R, Hammersley M, Turner R: Discrimination, adjusted correlation, and equivalence of imprecise tests: application to glucose tolerance. Am J Physiol 1999; 276: E365– E375

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner