ESPE Abstracts (2014) 82 P-D-2-3-348

Early Detection and Treatment of Cystic Fibrosis Related Diabetes Mellitus in a Tertiary Paediatric Centre: a Case Series

Eirin Carolana, Claire Murphya, Caoimhe Howarda, Dubhfeasa Slatteryb, Fiona Healyb, Ciara Mc Donnella & Nuala Murphya

aDepartment of Diabetes and Endocrinology, Children’s University Hospital, Temple Street, Dublin 1, Ireland; bDepartment of Respiratory Medicine, Children’s University Hospital, Temple Street, Dublin 1, Ireland

Background: Early recognition and treatment of cystic fibrosis related diabetes (CFRD) significantly improves respiratory and nutritional status of patients with cystic fibrosis (CF). American Diabetes Association (ADA) guidelines recommend annual screening with oral glucose tolerance test (OGTT) for all affected children from age 10 years.

Objective and hypothesis: We sought to determine if screening for CFRD was optimal and to determine if early treatment of CFRD improved respiratory and nutritional outcomes.

Methods: We retrospectively reviewed laboratory data for all CF patients >10 years and medical records of patients where OGTT was abnormal.

Results: Ninety-six CF patients aged 8.53±4.7 years attend our centre. All 47 patients (49% of total CF population) aged >10 years had annual OGTT. CFRD was diagnosed in 6 (6.3%) patients, two following lung transplantation. Four (4.1%) patients had impaired glucose tolerance and 1 (1%) had indeterminate glycaemia. Mean age at diagnosis of CFRD was 12.7±2.8 years. Mean HbA1c at diagnosis of CFRD was 55.5±22.2 mmol/mol, however two patients had normal HbA1c values. All patients were managed with subcutaneous insulin analogues. Predicted FEV1 values increased by 6±4.3% and BMI by 1.85±0.35 kg/m2 in CFRD patients 1 year post commencement of insulin therapy.

Conclusion: Early detection of CFRD allows prompt treatment and is associated with improved respiratory and nutritional outcomes.

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