Persistence of Residual Insulin Secretion in Long-Standing Cystic Fibrosis-Related Diabetes
Authors' conclusion
C-peptide levels in our cohort of PwCFRD were independent of diabetes duration, in contrast to PwT1D. A lower proinsulin-to-C-peptide ratio in PwCFRD compared to PwT1D suggested lower beta-cell dysfunction at fasting and stimulated evaluation. This supports the use of non-insulin therapies for adults with CFRD.
Study context
- Population
- Adults (≥18 years) with cystic fibrosis-related diabetes compared with people with T1DMMTT subset: 18 PwCFRD, 75 people with T1D (PwT1D)
- Participants
- 59 vs 1,185
- Exposure
- Adults with cystic fibrosis-related diabetes vs people with T1D
- PwCFRDn = 59
- PwT1Dn = 1,185reference
- Outcome
- Fasting C-peptide
Main finding
As reported in the abstract
PwCFRD
0.27
unspecified 0.34
PwT1D
0.00
unspecified 0.04
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Proinsulin-to-C-peptide ratio after mixed meal tolerance test · baseline and 2 hPwCFRD vs PwT1D · lower in PwCFRD at baseline | P < 0.001 |
| Proinsulin-to-C-peptide ratio after mixed meal tolerance test · baseline and 2 hPwCFRD vs PwT1D · lower in PwCFRD at 2 h | P = 0.001 |
- Proinsulin-to-C-peptide ratio after mixed meal tolerance test: subset of 18 PwCFRD and 75 PwT1D
Correlation of cystic fibrosis-related diabetes (CFRD) duration with C-peptide secretion
- Duration of CFRD did not correlate with C-peptide secretion
- P = 0.736
- After adjustment for HbA1c and insulin therapy
- P = 0.714
C-peptide secretion in PwCFRD by intravenous antibiotics in previous year
- Significantly lower C-peptide secretion in PwCFRD requiring IV antibiotics the previous year
- P = 0.042
C-peptide secretion in PwCFRD by CFTR modulator therapy
- No difference between patients receiving or not receiving CFTR modulator therapy
Original publication
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