RATIONALE Whether short-term glucose control in cystic fibrosis-related diabetes (CFRD) is associated with FEV1 recovery during acute pulmonary exacerbations is unclear. METHODS Data from all patients with CFRD ages 6-21 years hospitalized in 2010-2016 for pulmonary exacerbations at our CF Center were analyzed, including CFRD status at each encounter, all FEV1 recorded during each exacerbation, and relevant clinical covariates. Glucose control was analyzed using meter blood glucose area under the curve (AUC) indices. The primary outcome was FEV1 recovery. RESULTS Patients with CFRD who finished IV antibiotics at home were treated for longer than those fully treated in the hospital (22.2 vs. 13.8 days). In those who finished treatment at home, poor inpatient glycemic control was associated with lower lung function improvement: when comparing the 75th to the 25th percentile of each glycemic index (i.e., "poorer" vs. "better" glycemic control), FEV1 recovery at discharge was 20.1% lower for glucose AUC (95%CI -0.4%, -39.9%); 20.9% lower for 48-h AUC (95%CI -2.7%, -39.1%); and 28.2% lower for AUC/day (95%CI -7.1%, -49.3%). Similar results were found at the end of IV antibiotics and at clinic follow-up. Likewise, patients with poor glycemic control had a lower slope of inpatient FEV1 recovery. Analysis in patients with normal glucose tolerance was largely non-significant. No associations were found between hemoglobin A1c and FEV1 recovery. CONCLUSIONS In patients with CFRD who complete IV antibiotic treatment at home, poor inpatient glycemic control is associated with worse FEV1 recovery despite longer duration of treatment.

中文翻译：

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儿科囊性纤维化相关糖尿病肺部恶化期间的血糖控制和 FEV1 恢复

基本原理 囊性纤维化相关糖尿病 (CFRD) 的短期血糖控制是否与急性肺加重期间 FEV1 的恢复有关尚不清楚。方法 分析了 2010-2016 年在我们 CF 中心因肺部加重而住院的所有 6-21 岁 CFRD 患者的数据，包括每次就诊时的 CFRD 状态、每次加重期间记录的所有 FEV1 以及相关的临床协变量。使用血糖曲线下面积(AUC)指数分析葡萄糖控制。主要结果是 FEV1 恢复。结果 在家完成 IV 抗生素治疗的 CFRD 患者的治疗时间比在医院完全治疗的患者长（22.2 天 vs. 13.8 天）。在那些在家完成治疗的患者中，住院患者血糖控制不佳与肺功能改善较低有关：当比较每个血糖指数的第 75 个百分位数和第 25 个百分位数（即“较差”与“较好”血糖控制）时，出院时的 FEV1 回收率对于葡萄糖 AUC 降低 20.1%（95%CI -0.4%，-39.9%） ; 48 小时 AUC 降低 20.9% (95% CI -2.7%, -39.1%)；AUC/天降低 28.2%（95%CI -7.1%，-49.3%）。在静脉注射抗生素结束和临床随访时发现了类似的结果。同样，血糖控制不佳的患者住院 FEV1 恢复的斜率较低。对糖耐量正常的患者的分析在很大程度上是不显着的。未发现 A1c 血红蛋白与 FEV1 恢复之间存在关联。结论 在在家完成静脉抗生素治疗的 CFRD 患者中，尽管治疗持续时间较长，但住院患者血糖控制不佳与 FEV1 恢复较差相关。