Nutritional decline in cystic fibrosis related diabetes: the effect of intensive nutritional intervention.

Hdl Handle:
http://hdl.handle.net/10147/207809
Title:
Nutritional decline in cystic fibrosis related diabetes: the effect of intensive nutritional intervention.
Authors:
White, H; Pollard, K; Etherington, C; Clifton, I; Morton, A M; Owen, D; Conway, S P; Peckham, D G
Affiliation:
Adult Cystic Fibrosis Unit, St James' Hospital, Leeds, UK; Leeds Metropolitan, University, Leeds, UK. H.White@leedsmet.ac.uk
Citation:
J Cyst Fibros. 2009 May;8(3):179-85.
Journal:
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis, Society
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207809
DOI:
10.1016/j.jcf.2008.12.002
PubMed ID:
19179122
Abstract:
BACKGROUND: Reports indicate that nutritional and respiratory decline occur up to four years prior to diagnosis of cystic fibrosis related diabetes (CFRD). Our aim was to establish whether intensive nutritional intervention prevents pre-diabetic nutritional decline in an adult population with CFRD. METHODS: 48 adult patients with CFRD were matched to 48 controls with CF, for age, gender and lung pathogen status. Nutritional and other clinical indices were recorded at annual intervals from six years before until two years after diagnosis. Data were also analysed to examine the impact of early and late acquisition of CFRD. RESULTS: No important differences in weight, height, body mass index (BMI), lung function or intravenous treatment were found between groups in the six years prior to diagnosis, nor any significant deviation over time. In those who developed diabetes, use of overnight enteral tube feeding (ETF) was four times as likely at the time of diagnosis, compared to controls [ETF 43.8% (CFRD) v 18.8% (CF Controls), OR 4.0, CI 1.3 to 16.4, p=0.01]. Age at onset of CFRD played a significant role in determining the pre-diabetic clinical course. Younger diabetics with continued growth at study onset (n=17) had a lower BMI from 2 years prior to diagnosis compared to controls [BMI 18.9 kg/m(2) (CFRD) v 20.8 kg/m(2) (CF Controls), diff=1.9, CI -0.1 to 3.7 p=0.04]. The BMI of older diabetics (completed growth at study onset) was equal to that of controls throughout. CONCLUSION: Pre-diabetic nutritional decline is not inevitable in adults with CFRD, but is influenced by age of onset. In the group overall, those with CFRD are more likely to require ETF from 2 years prior to diagnosis. Despite intensive nutritional intervention, patients who continue to grow throughout the pre-diabetic years, show a level of nutritional decline absent in older adults.
Language:
eng
MeSH:
Adult; Age Factors; Body Mass Index; Case-Control Studies; Cystic Fibrosis/*complications; Diabetes Mellitus/*diet therapy/etiology; Dietary Supplements; Disease Progression; Enteral Nutrition; Female; Humans; Male; Nutrition Disorders/etiology/*prevention & control; Nutritional Status; Prediabetic State/*diet therapy/etiology; Young Adult
ISSN:
1873-5010 (Electronic); 1569-1993 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorWhite, Hen_GB
dc.contributor.authorPollard, Ken_GB
dc.contributor.authorEtherington, Cen_GB
dc.contributor.authorClifton, Ien_GB
dc.contributor.authorMorton, A Men_GB
dc.contributor.authorOwen, Den_GB
dc.contributor.authorConway, S Pen_GB
dc.contributor.authorPeckham, D Gen_GB
dc.date.accessioned2012-02-01T10:45:19Z-
dc.date.available2012-02-01T10:45:19Z-
dc.date.issued2012-02-01T10:45:19Z-
dc.identifier.citationJ Cyst Fibros. 2009 May;8(3):179-85.en_GB
dc.identifier.issn1873-5010 (Electronic)en_GB
dc.identifier.issn1569-1993 (Linking)en_GB
dc.identifier.pmid19179122en_GB
dc.identifier.doi10.1016/j.jcf.2008.12.002en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207809-
dc.description.abstractBACKGROUND: Reports indicate that nutritional and respiratory decline occur up to four years prior to diagnosis of cystic fibrosis related diabetes (CFRD). Our aim was to establish whether intensive nutritional intervention prevents pre-diabetic nutritional decline in an adult population with CFRD. METHODS: 48 adult patients with CFRD were matched to 48 controls with CF, for age, gender and lung pathogen status. Nutritional and other clinical indices were recorded at annual intervals from six years before until two years after diagnosis. Data were also analysed to examine the impact of early and late acquisition of CFRD. RESULTS: No important differences in weight, height, body mass index (BMI), lung function or intravenous treatment were found between groups in the six years prior to diagnosis, nor any significant deviation over time. In those who developed diabetes, use of overnight enteral tube feeding (ETF) was four times as likely at the time of diagnosis, compared to controls [ETF 43.8% (CFRD) v 18.8% (CF Controls), OR 4.0, CI 1.3 to 16.4, p=0.01]. Age at onset of CFRD played a significant role in determining the pre-diabetic clinical course. Younger diabetics with continued growth at study onset (n=17) had a lower BMI from 2 years prior to diagnosis compared to controls [BMI 18.9 kg/m(2) (CFRD) v 20.8 kg/m(2) (CF Controls), diff=1.9, CI -0.1 to 3.7 p=0.04]. The BMI of older diabetics (completed growth at study onset) was equal to that of controls throughout. CONCLUSION: Pre-diabetic nutritional decline is not inevitable in adults with CFRD, but is influenced by age of onset. In the group overall, those with CFRD are more likely to require ETF from 2 years prior to diagnosis. Despite intensive nutritional intervention, patients who continue to grow throughout the pre-diabetic years, show a level of nutritional decline absent in older adults.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshBody Mass Indexen_GB
dc.subject.meshCase-Control Studiesen_GB
dc.subject.meshCystic Fibrosis/*complicationsen_GB
dc.subject.meshDiabetes Mellitus/*diet therapy/etiologyen_GB
dc.subject.meshDietary Supplementsen_GB
dc.subject.meshDisease Progressionen_GB
dc.subject.meshEnteral Nutritionen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshNutrition Disorders/etiology/*prevention & controlen_GB
dc.subject.meshNutritional Statusen_GB
dc.subject.meshPrediabetic State/*diet therapy/etiologyen_GB
dc.subject.meshYoung Adulten_GB
dc.titleNutritional decline in cystic fibrosis related diabetes: the effect of intensive nutritional intervention.en_GB
dc.contributor.departmentAdult Cystic Fibrosis Unit, St James' Hospital, Leeds, UK; Leeds Metropolitan, University, Leeds, UK. H.White@leedsmet.ac.uken_GB
dc.identifier.journalJournal of cystic fibrosis : official journal of the European Cystic Fibrosis, Societyen_GB
dc.description.provinceLeinster-

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