Evaluation of glucose tolerance in cystic fibrosis: Comparison of 50-g and 75-g tests☆

Abstract 

Background

The recommended tests for evaluation of glucose tolerance in cystic fibrosis are the fasting blood glucose (FBG) and the 75-g, fasting, 2-h oral glucose tolerance test (OGTT). We compared a 50 g, non-fasting, 1-h glucose challenge test (GCT) to the standard OGTT.

Methods

During their regularly scheduled visit to the cystic fibrosis clinic, patients underwent a 50-g, non-fasting 1-h GCT and were asked to complete a standard 75-g, fasting, 2-h OGTT within one week of their clinic visit.

Results

Fifty-seven patients underwent glucose tolerance testing. Of these, 31/57 (54%) completed both tests. Hyperglycemia was detected on both tests in 9/31 (29%) patients, 11/31 (35%) tested positive only on the GCT, while all those with positive OGTTs had positive GCTs (p<0.01).

Conclusions

In this study, the GCT identified all patients who meet the criteria for abnormal glucose tolerance on an OGTT. There was a large subgroup that was positive for glucose intolerance only on the GCT. These individuals represent a distinct biochemical subgroup of uncertain significance that warrants closer evaluation. Although the GCT can be completed in a non-fasting state and in conjunction with regular blood work or clinic visits, the anticipated greater compliance was not seen.

Keywords: Glucose tolerance testing, Oral glucose tolerance test, Glucose challenge test, Cystic fibrosis-related diabetes