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Changements phénotypiques de la mucoviscidose, à propos du diabète associé à la mucoviscidose : évolution naturelle des troubles du métabolisme glucidique, impact pronostique et stratégie de dépistage

Abstract : Life expectancy improvement for cystic fibrosis patients is associated with comorbidities with diabetes being the most common. The objective of this work is to better determine the prognosis impact of diabetes and high values of early times of the oral glucose tolerance test (OGTT). We present and discuss four studies on the natural evolution and prognosis impact of glucose metabolism disorders associated with cystic fibrosis. We then present two studies on the impact of diabetes in specific situations: pregnancy and lung transplantation. The following elements are important: changes in intra-individual glucose status are very important over time, and our results qualify the pejorative impact of diabetes described in the literature, and that of high blood glucose and insulin levels at one hour of the OGTT. The research perspectives are to continue the implementation of the GLYCONE cohort to increase the number of participants and the duration of follow-up, to evaluate the association between dietary intake and carbohydrate metabolism disorder, to develop a shared medical decision-making process for the introduction of insulin therapy for stable patient profiles, to determine the consumption of care and the costs of management of diabetic patients, and evaluate the epidemiological changes induced by CFTR modulators on the prevalence and the age of onset of diabetes and its prognosis
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https://tel.archives-ouvertes.fr/tel-02898230
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Submitted on : Monday, July 13, 2020 - 3:54:12 PM
Last modification on : Tuesday, July 14, 2020 - 3:39:44 AM

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Quitterie Reynaud. Changements phénotypiques de la mucoviscidose, à propos du diabète associé à la mucoviscidose : évolution naturelle des troubles du métabolisme glucidique, impact pronostique et stratégie de dépistage. Santé. Université de Lyon, 2019. Français. ⟨NNT : 2019LYSE1292⟩. ⟨tel-02898230⟩

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