As the life expectancy of patients with Cystic Fibrosis (CF) increases the significance of the diagnosis of CF related diabetes (CFRD) has become apparent. There is evidence that CFRD has deleterious effects upon lung function and mortality. In 2006 a state-wide adult CF service was instituted in Tasmania with the involvement of two adult endocrinologists.
To describe the differences between adult patients with and without CFRD attending the Tasmanian CF service.
We reviewed the notes of 48 consecutive adult patients (age >17 years) attending the Tasmanian CF service in March 2013. Axiological data, the diagnosis and duration of CFRD, predicted Forced Expiratory Volume (FEV1), glycosylated haemoglobin (HbA1c), renal and liver function, urinary albumin excretion, treatment of diabetes, genotype, sputum culture, presence of retinopathy and bone mineral density (BMD) were obtained.
32/48 (66%) patients were male and 24(50%) had a diagnosis of CFRD. 10/48 patients had bilateral lung transplantations. Age (34.6 +/-2 vs. 26.7 +/-2.4 yrs) and HbA1c (7.7 +/- 0.1 vs. 5.6 +/- 0.4%) were higher in patients with CFRD compared to non-CFRD. FEV1 (55.4 +/- 4.7 vs. 62.5 +/- 4.4%) and T score at the femoral neck were reduced in CFRD compared to non-CFRD (-1.19 +/- 0.2 vs. -0.43 +/- 0.2). 23/24 patients with CFRD were treated with insulin and 1/24 patient was treated with a sulphonylurea. 3/9 patients with CFRD had evidence of microalbuminuria.
Adult CF patients in Tasmania are at high risk of developing CFRD and its associated co-morbidities. The importance of a dedicated multidisciplinary team in carrying out surveillance and treatment is demonstrated.