Insulin Therapy to Improve BMI in Cystic Fibrosis–Related Diabetes Without Fasting Hyperglycemia
Open accessAbstract
OBJECTIVE: Cystic fibrosis-related diabetes (CFRD) without fasting hyperglycemia (CFRD FH-) is not associated with microvascular or macrovascular complications, leading to controversy about the need for treatment. The Cystic Fibrosis Related Diabetes Therapy (CFRDT) Trial sought to determine whether diabetes therapy improves BMI in these patients. RESEARCH DESIGN AND METHODS: A three-arm multicenter randomized trial compared 1 year of therapy with premeal insulin aspart, repaglinide, or oral placebo in subjects with cystic fibrosis who had abnormal glucose tolerance. RESULTS: One hundred adult patients were enrolled. Eighty-one completed the study, including 61 with CFRD FH- and 20 with severly impaired glucose tolerance (IGT). During the year before therapy, BMI declined in all groups. Among the group with CFRD FH-, insulin-treated patients lost 0.30 +/- 0.21 BMI units the year before therapy. After 1 year of insulin therapy, this pattern reversed, and they gained 0.39 +/- 21 BMI units (P = 0.02). No significant change in the rate of BMI decline was seen in placebo-treated patients (P = 0.45). Repaglinide-treated patients had an initial significant BMI gain (0.53 +/- 0.19 BMI units, P = 0.01), but this effect was not sustained. After 6 months of therapy they lost weight so that by 12 months there was no difference in the rate of BMI change during the study year compared with the year before (P = 0.33). Among patients with IGT, neither insulin nor repaglinide affected the rate of BMI decline. No significant differences were seen in the rate of lung function decline or the number of hospitalizations in any group. CONCLUSIONS: Insulin therapy safely reversed chronic weight loss in patients with CFRD FH-.
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CFRD mortality has significantly decreased over time, and the gap in mortality between people with cystic fibrosis with and without diabetes has considerably narrowed.
“CFRD mortality has signi fi cantly decreased over time, and the gap in mortality between people with cystic fi brosis with and without diabetes has considerably narrowed (135).”
From 2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [135]
The introductory passage following the Abstract’s Conclusions says that cystic fibrosis life expectancy has increased with advances in care, but it does not report a decline in CFRD mortality or a narrowing mortality gap between people with and without diabetes. The trial’s Conclusions discuss weight loss and possible effects on survival, not mortality trends. Searches for CFRD mortality trends and a narrowing gap found no passage addressing the claim. (LLM, conf=0.75)
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Cites
Prediction of mortality in patients with cystic fibrosis
Kerem, E., Reisman, J., Corey, M., Canny, G. J., & Levison, H. (1992) · New England Journal of Medicine · doi:10.1056/nejm199204303261804 · Cited by 993 · see citing works
Corey, M. L., McLaughlin, F. J., Williams, M., & Levison, H. (1988) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(88)90063-7 · Cited by 812 · see citing works
Milla, C. E., Warwick, W. J., & Moran, A. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.162.3.9904075 · Cited by 367 · see citing works
Self-citationSulfonylurea Induced β-Cell Apoptosis in Cultured Human Islets
Maedler, K., Carr, R. D., Bosco, D., Zuellig, R. A., Berney, T., & Donath, M. Y. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0699 · Cited by 337 · see citing works
Diagnosis, screening and management of cystic fibrosis related diabetes mellitus
Moran, A., Hardin, D. S., Rodman, D. M., Allen, H. F., Beall, R. J., Borowitz, D., Brunzell, C., Campbell, P., Chesrown, S. E., Duchow, C., et al. (1999) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(99)00058-3 · Cited by 290 · see citing works
Self-citationA new prognostic score and clinical evaluation system for cystic fibrosis
Taussig, L. M., Kattwinkel, J., Friedewald, W. T., & di Sant'Agnese, P. A. (1973) · The Journal of Pediatrics · doi:10.1016/s0022-3476(73)80110-6 · Cited by 265 · see citing works
Diabetes mellitus in cystic fibrosis: effect of insulin therapy on lung function and infections
Lanng, S., Thorsteinsson, B., Nerup, J., et al. (1994) · Acta Paediatrica · doi:10.1111/j.1651-2227.1994.tb13156.x · Cited by 212 · see citing works
Milla, C. E., Billings, J. L., & Moran, A. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2141 · Cited by 210 · see citing works
Self-citationMicrovascular Complications in Cystic Fibrosis–Related Diabetes
Schwarzenberg, S. J., Thomas, W. T. B., Olsen, T. W., Grover, T., Walk, D., Milla, C. E., & Moran, A. (2007) · Diabetes Care · doi:10.2337/dc06-1576 · Cited by 199 · see citing works
Self-citationModi, A. C. (2003) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsg044 · Cited by 191 · see citing works
Abnormal glucose metabolism in cystic fibrosis
Moran, A., Doherty, L., Wang, X., et al. (1998) · The Journal of Pediatrics · doi:10.1016/s0022-3476(98)70171-4 · Cited by 170 · see citing works
Self-citationAlvarsson, M., Sundkvist, G., Lager, I., Henricsson, M., Berntorp, K. E., Fernqvist‐Forbes, E., Steen, L., Westermark, G. T., Westermark, P., Örn, T., et al. (2003) · Diabetes Care · doi:10.2337/diacare.26.8.2231 · Cited by 170 · see citing works
Determinants of adherence in adults with cystic fibrosis
Kettler, L. J. (2002) · Thorax · doi:10.1136/thorax.57.5.459 · Cited by 147 · see citing works
Rolón, M. D. V., Benali, K., Munck, À., Navarro, J., Clément, A., Tubiana‐Rufi, N., Czernichow, P., & Polak, M. (2001) · Acta Paediatrica · doi:10.1111/j.1651-2227.2001.tb02446.x · Cited by 144 · see citing works
Mozzillo, E., Franzese, A., Valerio, G., et al. (2009) · Pediatric Diabetes · doi:10.1111/j.1399-5448.2008.00451.x · Cited by 108 · see citing works
Long-Term Effect of Insulin Treatment in Cystic Fibrosis-Related Diabetes
Mohan, K., Israel, K. L., Miller, H., et al. (2007) · Respiration · doi:10.1159/000110206 · Cited by 97 · see citing works
Insulin improves clinical status of patients with cystic-fibrosis-related diabetes mellitus
Nousia‐Arvanitakis, S., Galli‐Τsinopoulou, A., & Karamouzis, M. (2001) · Acta Paediatrica · doi:10.1111/j.1651-2227.2001.tb00791.x · Cited by 97 · see citing works
Bizzarri, C., Lucidi, V., Ciampalini, P., Bella, S., Russo, B., & Cappa, M. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03345538 · Cited by 89 · see citing works
(1998) · PubMed · Cited by 85 · see citing works
Moran, A., Phillips, J. W., & Milla, C. E. (2001) · Diabetes Care · doi:10.2337/diacare.24.10.1706 · Cited by 82 · see citing works
Self-citationMoran, A., Milla, C. E., duCret, R. P., & Nair, K. S. (2001) · Diabetes · doi:10.2337/diabetes.50.6.1336 · Cited by 78 · see citing works
Self-citationProteolysis Associated With Insulin Resistance in Cystic Fibrosis
Hardin, D. S., Leblanc, A., Lukenbaugh, S., et al. (1998) · PEDIATRICS · doi:10.1542/peds.101.3.433 · Cited by 69 · see citing works
Insulin improves clinical status of patients with cystic-fibrosis-related diabetes mellitus
Nousia‐Arvanitakis, S., Galli‐Τsinopoulou, A., & Karamouzis, M. (2001) · Acta Paediatrica · doi:10.1080/080352501750197647 · Cited by 67 · see citing works
Sockrider, M. M., Swank, P. R., Seilheimer, D. K., et al. (1994) · Pediatric Pulmonology · doi:10.1002/ppul.1950170204 · Cited by 48 · see citing works
Brusco, A., Michielotto, C., Gatta, V., et al. (2006) · Journal of Endocrinological Investigation · doi:10.1007/bf03349169 · Cited by 39 · see citing works
Moran, A., Basu, R., Milla, C. E., & Jensen, M. D. (2004) · Metabolism · doi:10.1016/j.metabol.2004.06.015 · Cited by 27 · see citing works
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2. Classification and Diagnosis of Diabetes: <i>Standards of Medical Care in Diabetes—2018</i>
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dc18-s002 · Cited by 3,159 · see citing works
2. Diagnosis and Classification of Diabetes: <i>Standards of Care in Diabetes—2024</i>
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Gaglia, J. L., Hilliard, M. E., Johnson, E. L., et al. (2024) · Diabetes Care · doi:10.2337/dc24-s002 · Cited by 2,086 · see citing works
(2) Classification and diagnosis of diabetes
American Diabetes Association (2015) · Diabetes Care · doi:10.2337/dc15-s005 · Cited by 1,841 · see citing works
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2. Diagnosis and classification of diabetes: standards of care in diabetes-2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s002 · Cited by 1,393 · see citing works
Moran, A., Pillay, K., Becker, D., Granados, A., Hameed, S., & Acerini, C. L. (2018) · Pediatric Diabetes · doi:10.1111/pedi.12732 · Cited by 171 · see citing works
Self-citationNew insights into cystic fibrosis-related diabetes in children
Ode, K. L., & Moran, A. (2013) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(13)70015-9 · Cited by 76 · see citing works
Self-citationBallmann, M., Hubert, D., Assael, B. M., Staab, D., Hebestreit, A., Naehrlich, L., Nickolay, T., Prinz, N., Holl, R. W., Staden, U., et al. (2018) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(17)30400-x · Cited by 71 · see citing works
Gilmour, J. A., Sykes, J., Etchells, E., & Tullis, E. (2019) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2018.04.008 · Cited by 51 · see citing works
Self-citationPutman, M. S., Norris, A. W., Hull, R. L., Rickels, M. R., Sussel, L., Blackman, S. M., Chan, C. L., Ode, K. L., Daley, T., Stecenko, A. A., et al. (2023) · Diabetes Care · doi:10.2337/dc23-0380 · Cited by 35 · see citing works
Self-citation
- Authors
- Moran, A., Pekow, P., Grover, P., Zorn, M., Slovis, B., Pilewski, J., Tullis, E., Liou, T. G., Allen, H., & the Cystic Fibrosis Related Diabetes Therapy Study Group
- Affiliations
- University of Minnesota (US)
- University of Massachusetts Amherst (US)
- Vanderbilt University (US)
- University of Pittsburgh (US)
- St. Michael's Hospital (CA)
- University of Utah (US)
- Tufts University (US)
- Corresponding author
- Moran, Antoinette
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-07-10
- Volume
- 32
- Issue
- 10
- Pages
- 1783-1788
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2752940
- OpenAlex
- W2080318972
- Cited by
- 240
- References
- 26
- Citations by year
- 2026: 18 · 2025: 5 · 2024: 11 · 2023: 18 · 2022: 16 · 2021: 24 · 2020: 9 · 2019: 19 · 2018: 12 · 2017: 11 · 2016: 15 · 2015: 17 · 2014: 17 · 2013: 12 · 2012: 6
- FWCI
- 10.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Cystic Fibrosis Foundation
- Novo Nordisk
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK58356, R01DK058356)
- National Center for Research Resources (M01RR000400, M01-RR00400)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- cystic fibrosis-related diabetes, insulin therapy, repaglinide, body mass index, weight loss, impaired glucose tolerance, fasting hyperglycemia, lung function decline, hospitalization
- MeSH terms
- Adult, Cystic Fibrosis, Diabetes Mellitus, Female, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Male, Body Mass Index
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