Use of the insulin pump in treat cystic fibrosis related diabetes

Objectives: This study was conducted to determine efficacy and tolerability of the continued subcutaneous insulin infusion (CSII) via an insulin pump for treatment of Cystic Fibrosis Related Diabetes (CFRD). We also tested the hypothesis that CSII would improve body weight, blood sugar control, lean body mass, whole body protein tumover, hepatic glucose production (HGP). Methods: We recruited 9 CF patients with established diabetes and placed them on insulin pump therapy for six months. Each subject kept daily blood sugar records before and during pump use. Prior to the pump placement and at the end of six months, each patient underwent the following measurements: 1) whole body protein turnover using the stable isotope [l-C-13] leucine; 2) DEXA scan for measurement of lean body mass; leucine, 3) anthropometric measurements-, 4) Hemoglobin Ale. Patient data was compared to baseline data and the mean change from baseline was analyzed. Results: There was significant improvement in both fasting and post-prandial blood glucose levels, body weight, HbAlC, and lean mass. Protein catabolism as measured by leucine rate of appearance was significantly lower, as was hepatic glucose production. No patient developed hypoglycemia during the study. Conclusions: This study demonstrates that CSII is safe and effective for treatment of CFRD and that metabolic benefits are also present. (C) 2008 Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.