ESPE Abstracts (2014) 82 P-D-1-3-88

Improved Health-related Quality of Life with Insulin Therapy in Children with Cystic Fibrosis-related Diabetes: a Prospective Cohort Study

Sherly Georgea,h, Hilary M C V Hoeyb,d, Colm Costiganc, Nuala Murphye, Edna F Rocheb,d & Stephen M P O’Riordanf,g

aUniversity College Dublin, Dublin, Ireland; bTrinity College Dublin, Dublin, Ireland; cOur Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland; dAdelaide and Meath Hospital Incorporating National Children’s Hospital, Tallaght, Dublin, Ireland; eThe Children’s University Hospital, Temple Street, Dublin, Ireland; fCork University Hospital, Cork, Ireland; gUniversity College Cork, Cork, Ireland; hCoombe Women and Infants University Hospital, Dublin, Ireland

Background: Cystic fibrosis-related diabetes (CFRD) is a common complication in cystic fibrosis (CF). CFRD symptoms and treatment may impose additional burden and adversely affect their QoL.

Objective and hypotheses: Assess HRQoL in CF children with normal glycaemia (CFN) and CFRD and evaluate the change in HRQoL over 1 year period along with clinical changes.

Method: A prospective study was undertaken including children aged 10–18 years attending the three paediatric CF clinics in Dublin. Collected clinical and demographic data at baseline and at 12 months. Based on the paired OGTT and CGMS patients were classified as CFRD and CFN. HRQoL was assessed using KIDSCREEN-10 and DISABKIDS CFM questionnaires. Total score ranged 0–100, higher the score better HRQoL.

Results: A total of 103 patients (55 males) were recruited, mean age (14±2.6) years and BMI (18.7±3.0) kg/m2. At baseline 12 (12%) CFRD patients were on insulin. They were older (16 vs 14, P<0.01), with lower FEV1% predicted (48 vs 70, P<0.005), but no difference in BMI. After 1 year, 24 (24%) CFRD patients were on insulin. CFRD group had lower overall HRQoL than CFN at baseline (50.3±9.2 vs 53.6±10.6) and follow-up (48.1±10.2 vs 53.4±10.2) and significantly decreased over 1 year (P<0.01). The impact score was significantly lower in CFRD in both assessments (51±33.8 vs 70.4±22.1, P<0.01) and (54.2±25 vs 67.3±25, P<0.05). This improved after 1 year in CFRD but not in CFN. CFRD group had better treatment scores at baseline (68.1±26.3) than impact score; this was higher than the CFN group (67.2±21.3). This improvement in treatment score was correlated to the reduction in symptoms once insulin was started over the 12 months study period.

Conclusion: CFRD adversely affects patient’s QOL. Insulin therapy improves symptoms and thus improved QoL. Further regression analysis is warranted to assess the independent predictors of QOL.

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