Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED)
Cystic fibrosis related diabetes (CFRD) is a comorbidity of cystic fibrosis (CF) that negatively impacts on its clinical course. Prediabetes is an important predictor of either CFRD development and unfavorable prognosis of CF in both pediatric and adult patients. International guidelines recommend i...
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Format: | Article |
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Frontiers Media S.A.
2021-04-01
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Series: | Frontiers in Endocrinology |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.673539/full |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Enza Mozzillo Roberto Franceschi Claudia Piona Stefano Passanisi Alberto Casertano Dorina Pjetraj Giulio Maltoni Valeria Calcaterra Vittoria Cauvin Valentino Cherubini Giuseppe D’Annunzio Adriana Franzese Anna Paola Frongia Fortunato Lombardo Donatella Lo Presti Maria Cristina Matteoli Elvira Piccinno Barbara Predieri Ivana Rabbone Andrea Enzo Scaramuzza Sonia Toni Stefano Zucchini Claudio Maffeis Riccardo Schiaffini |
spellingShingle |
Enza Mozzillo Roberto Franceschi Claudia Piona Stefano Passanisi Alberto Casertano Dorina Pjetraj Giulio Maltoni Valeria Calcaterra Vittoria Cauvin Valentino Cherubini Giuseppe D’Annunzio Adriana Franzese Anna Paola Frongia Fortunato Lombardo Donatella Lo Presti Maria Cristina Matteoli Elvira Piccinno Barbara Predieri Ivana Rabbone Andrea Enzo Scaramuzza Sonia Toni Stefano Zucchini Claudio Maffeis Riccardo Schiaffini Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) Frontiers in Endocrinology cystic fibrosis-related diabetes prediabetes oral glucose tolerance test (OGTT) continuous glucose monitoring abnormal glucose tolerance systematic review |
author_facet |
Enza Mozzillo Roberto Franceschi Claudia Piona Stefano Passanisi Alberto Casertano Dorina Pjetraj Giulio Maltoni Valeria Calcaterra Vittoria Cauvin Valentino Cherubini Giuseppe D’Annunzio Adriana Franzese Anna Paola Frongia Fortunato Lombardo Donatella Lo Presti Maria Cristina Matteoli Elvira Piccinno Barbara Predieri Ivana Rabbone Andrea Enzo Scaramuzza Sonia Toni Stefano Zucchini Claudio Maffeis Riccardo Schiaffini |
author_sort |
Enza Mozzillo |
title |
Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) |
title_short |
Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) |
title_full |
Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) |
title_fullStr |
Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) |
title_full_unstemmed |
Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) |
title_sort |
diabetes and prediabetes in children with cystic fibrosis: a systematic review of the literature and recommendations of the italian society for pediatric endocrinology and diabetes (isped) |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2021-04-01 |
description |
Cystic fibrosis related diabetes (CFRD) is a comorbidity of cystic fibrosis (CF) that negatively impacts on its clinical course. Prediabetes is an important predictor of either CFRD development and unfavorable prognosis of CF in both pediatric and adult patients. International guidelines recommend insulin only in case of CFRD diagnosis. Whether early detection and treatment of prediabetes may contribute to improve the clinical course of CF is still debated. A subgroup of pediatric diabetologists of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED) performed a systematic review of the literature based on predefined outcomes: impact of pre-diabetes on clinical outcomes and on the risk of developing CFRD; diagnosis of diabetes and pre-diabetes under 10 years of age; effectiveness of therapy on glycemic control, impact of therapy on pulmonary function and nutritional status. Thirty-one papers were selected for the analysis data presented in these papers were reported in tables sorted by outcomes, including comprehensive evidence grading according to the GRADE approach. Following the grading of the quality of the evidence, the entire ISPED diabetes study group achieved consensus for the Italian recommendations based on both evidence and clinical experience. We concluded that in patients with CF, prediabetes should be carefully considered as it can evolve into CFRD. In patients with CF and prediabetic conditions, after complete evaluation of the OGTT trend, glucometrics, glycemic values measured during pulmonary exacerbations and/or steroid therapy, early initiation of insulin therapy could have beneficial effects on clinical outcomes of patients with CF and prediabetes. |
topic |
cystic fibrosis-related diabetes prediabetes oral glucose tolerance test (OGTT) continuous glucose monitoring abnormal glucose tolerance systematic review |
url |
https://www.frontiersin.org/articles/10.3389/fendo.2021.673539/full |
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doaj-6cc16a624653486bb8df378c76dcc8542021-05-04T15:08:02ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-04-011210.3389/fendo.2021.673539673539Diabetes and Prediabetes in Children With Cystic Fibrosis: A Systematic Review of the Literature and Recommendations of the Italian Society for Pediatric Endocrinology and Diabetes (ISPED)Enza Mozzillo0Roberto Franceschi1Claudia Piona2Stefano Passanisi3Alberto Casertano4Dorina Pjetraj5Giulio Maltoni6Valeria Calcaterra7Vittoria Cauvin8Valentino Cherubini9Giuseppe D’Annunzio10Adriana Franzese11Anna Paola Frongia12Fortunato Lombardo13Donatella Lo Presti14Maria Cristina Matteoli15Elvira Piccinno16Barbara Predieri17Ivana Rabbone18Andrea Enzo Scaramuzza19Sonia Toni20Stefano Zucchini21Claudio Maffeis22Riccardo Schiaffini23Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, ItalyPediatric Unit, S. Chiara Hospital, Trento, ItalyRegional Center for Pediatric Diabetes, University of Verona, Verona, ItalyDepartment of Human Pathology in Adult and Developmental Age, University of Messina, Messina, ItalyDepartment of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, ItalySOD Pediatric Diabetology, Department of Women’s and Children’s, “G. Salesi” Children’s Hospital, AOU Ospedali Riuniti, Ancona, ItalyDepartment of Woman, Child and Urological Diseases, S. Orsola-Malpighi University Hospital, Bologna, ItalyUniversity of Pavia, Pavia and Department of Pediatrics, "Vittore Buzzi" Children’s Hospital, Milano, ItalyPediatric Unit, S. Chiara Hospital, Trento, ItalySOD Pediatric Diabetology, Department of Women’s and Children’s, “G. Salesi” Children’s Hospital, AOU Ospedali Riuniti, Ancona, ItalyIRCCS Istituto Giannina Gaslini, Genova, ItalyDepartment of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, ItalyDiabetes Unit, Ospedale Brotzu, Cagliari, ItalyDepartment of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy0Centro di Riferimento Regionale di Diabetologia Pediatrica A.O.U. Policlinico G. Rodolico, Catania, Italy1Diabetes Unit, Bambino Gesù Children’s Hospital, Rome, Italy2D.A.I. Pediatria, Ospedale Pediatrico Giovanni XXIII, Bari, Italy3Department of Medical and Surgical Sciences of the Mother, Children and Adults - Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy4Division of Pediatrics, Department of Health Science, University of Piemonte Orientale, Novara, Italy5Diabetes & Nutrition Unit, Pediatrics, ASST Cremona, Cremona, Italy6Pediatric Diabetology Unit, Meyer Children Hospital, Florence, ItalyDepartment of Woman, Child and Urological Diseases, S. Orsola-Malpighi University Hospital, Bologna, ItalyRegional Center for Pediatric Diabetes, University of Verona, Verona, Italy1Diabetes Unit, Bambino Gesù Children’s Hospital, Rome, ItalyCystic fibrosis related diabetes (CFRD) is a comorbidity of cystic fibrosis (CF) that negatively impacts on its clinical course. Prediabetes is an important predictor of either CFRD development and unfavorable prognosis of CF in both pediatric and adult patients. International guidelines recommend insulin only in case of CFRD diagnosis. Whether early detection and treatment of prediabetes may contribute to improve the clinical course of CF is still debated. A subgroup of pediatric diabetologists of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED) performed a systematic review of the literature based on predefined outcomes: impact of pre-diabetes on clinical outcomes and on the risk of developing CFRD; diagnosis of diabetes and pre-diabetes under 10 years of age; effectiveness of therapy on glycemic control, impact of therapy on pulmonary function and nutritional status. Thirty-one papers were selected for the analysis data presented in these papers were reported in tables sorted by outcomes, including comprehensive evidence grading according to the GRADE approach. Following the grading of the quality of the evidence, the entire ISPED diabetes study group achieved consensus for the Italian recommendations based on both evidence and clinical experience. We concluded that in patients with CF, prediabetes should be carefully considered as it can evolve into CFRD. In patients with CF and prediabetic conditions, after complete evaluation of the OGTT trend, glucometrics, glycemic values measured during pulmonary exacerbations and/or steroid therapy, early initiation of insulin therapy could have beneficial effects on clinical outcomes of patients with CF and prediabetes.https://www.frontiersin.org/articles/10.3389/fendo.2021.673539/fullcystic fibrosis-related diabetesprediabetesoral glucose tolerance test (OGTT)continuous glucose monitoringabnormal glucose tolerancesystematic review |