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

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    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
    Issue Date
    2012-02-01T10:45:19Z
    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
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    Citation
    J Cyst Fibros. 2009 May;8(3):179-85.
    Journal
    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis, Society
    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
    ISSN
    1873-5010 (Electronic)
    1569-1993 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jcf.2008.12.002
    Scopus Count
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