ePostersLive by SCIGEN TECHNOLOGIES
26 posters, 
6 sessions, 
105 authors, 
32 institutions

5

A retrospective review of the epidemiology of cystic fibrosis related diabetes in adult cystic fibrosis patients, Johannesburg, South Africa

Friday, 27 May, 2011 - 11:32
Board 1

Cystic fibrosis (CF) is a common fatal autosomal recessive inherited condition affecting the Caucasian population with an incidence of 1 per 2500 live births . Survival rates among cystic fibrosis patients have improved due to optimal medical management and the current life expectancy is around 37.4 years according to the CF Foundation Registry1. As a consequence of improved survival, later complications may develop such as cystic fibrosis related diabetes (CFRD) and cystic fibrosis related bone disease. The risk for developing CFRD is increased with increasing age, presence of exocrine pancreatic insufficiency, DF508 homozygous genotype, lower BMI and female gender2

Part of Session

General Critical Care

Full Text

IntroductionCystic fibrosis (CF) is a common fatal autosomal recessive inherited condition affecting the Caucasian population with an incidence of 1 per 2500 live births . Survival rates among cystic fibrosis patients have improved due to optimal medical management and the current life expectancy is around 37.4 years according to the CF Foundation Registry1. As a consequence of improved survival, later complications may develop such as cystic fibrosis related diabetes (CFRD) and cystic fibrosis related bone disease. The risk for developing CFRD is increased with increasing age, presence of exocrine pancreatic insufficiency, DF508 homozygous genotype, lower BMI and female gender2
Aims and The aims of the study were to determine the prevalence of CFRD in the population of CF patients attending the adult CF clinic at Charlotte Maxeke Johannesburg academic hospital and to determine the characteristics of the patients with CFRD in terms of age, gender, genotype, lung function, body mass index (BMI), HBA1c, use of corticosteroids and pancreatic function. There is currently no data available in South Africa regarding these statistics.

The prevalence values were to be compared with other CF centres. A recent study of the Dutch CF population showed the prevalence of CFRD to be 52% in patients older than 40 years2. The CF patient group receiving treatment at the University of Minnesota in America had a prevalence of CFRD of 2% of children, 19% of adolescents and 40-50% of adults3.Materials & MethodsA retrospective patient file review was conducted on all the patient files in the Adult Cystic Fibrosis Unit, Charlotte Maxeke Johannesburg academic hospital. Patients were classified as having normal glucose tolerance, impaired glucose tolerance or CFRD based on the results of oral glucose tolerance testing (OGTT). For statistical analysis, patients with impaired glucose tolerance and CFRD were analyzed together under the group abnormal glucose homeostasis. 50 patient files were reviewed. Results

The prevalence of CFRD was 54 %. 75 % of patients had abnormal glucose homeostasis. Statistical analysis failed to demonstrate any significant difference in the characteristics of patients with and without CFRD. This may be related to the small sample size. HBA1c values were higher in patients with abnormal glucose homeostasis compared to patients with normal glucose tolerance.

ConclusionsThe prevalence of CFRD in the adult cystic fibrosis population at Charlotte Maxeke Johannesburg Academic Hospital correlates with the prevalence of CFRD in other cystic fibrosis centers. There were no statistically significant differences in the characteristics of patients with and without CFRD.References1. Marshall, B.C., Butler, S.M., Stoddard, M., Moran, A.M., Liou, T.G., Morgan, W.J. & Asthana, S. 2005, "Epidemiology of cystic fibrosis-related diabetes", Journal of Pediatrics, vol. 146, no. 5, pp. 681-687.

2. van den Berg, J.M.W., Kouwenberg, J.M. & Heijerman, H.G.M. 2009, "Demographics of glucose metabolism in cystic fibrosis", Journal of Cystic Fibrosis, vol. 8, no. 4, pp. 276-279.

3. Moran, A., Dunitz, J., Nathan, B., Saeed, A., Holme, B. & Thomas, W. 2009, "Cystic fibrosis-related diabetes: Current trends in prevalence, incidence, and mortality", Diabetes care, vol. 32, no. 9, pp. 1626-1631.