The purpose of this study is to evaluate whether the anticipated use of glargine in CF patients with glucose intolerance may prevent the worsening of nutritional status and pulmonary function.
Diabetes mellitus may often complicate the cystic fibrosis course, and it is usually preceded by a condition defined as glucose intolerance, during which a significant decay of patient's general conditions is observed. A slow release insulin (glargine) has become available in the market for diabetic patients: its characteristics allow for a single daily dose, and no need of repeated daily monitoring of glycemia. In this randomized controlled clinical trial we evaluate whether the anticipated use of glargine in CF patients with glucose intolerance may prevent the worsening of nutritional status and pulmonary function. Eligible patients who will accept to participate to this study will be randomly allocated in the group who will or will not receive glargine as additional supportive therapy. Patients will in any case continue the CF therapy prescribed by their treating physicians and their usual diet. All the patients will be evaluated every three months to assess their nutritional, pulmonary and glycometabolic status. The follow-up will continue until the 18th month after the study entry.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
70
Insulin Glargine will be administered subcutaneously at the dosage of 0.1 U/Kg/die for three months. In case no hypoglycemic episodes occur during this period, the dosage will be increased to 0.15 U/Kg/die in occasion of the first control (T1) and will be scheduled for other three months. If even during this latter period no cases no hypoglycemic episodes occur, at the second control (T2) the dosage will be increased to the maximum of 0.2/U/Kg/die. It is generally accepted that the final dosage of glargine can be tailored to each patient, but it should be maintained between 0.1 and 0.2 U/Kg/die. Glargine should be administered once daily in the morning and always at the same hour.
Pediatric Department, General Hospital,CF Center
Cerignola (Foggia), Italy
Ospedale Maggiore Policlinico, Adult CF Center
Milan, Italy
Pediatric Department, Federico II University, Pediatric CF Center
Napoli, Italy
Pediatric Department G.De Cristina Hospital CF Center
Palermo, Italy
Nutritional status evaluated as variations of Z score of BMI
Time frame: At recruitment time and at +3, +6, +9, +12, +15, +18 months
Glucose tolerance improvement evaluated as improvement of glycometabolic parameter (glycosylated Hb)
Time frame: At time recruitment and +3,+6,+9+12+15+18 months
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Bambino Gesù Hospital CF Center
Roma, Italy
Policlinico Umberto I. CF Center
Roma, Italy