Nicole Scheuing1, Gabriele Berger2, Dominik Bergis3, Bettina Gohlke4, Katja Konrad5, Katharina Laubner6, Eggert Lilienthal7, Christine Moser8, Ingrid Schütz-Fuhrmann9, Angelika Thon10, Reinhard W Holl11. 1. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, D-89081 Ulm, Germany. Electronic address: nicole.scheuing@uni-ulm.de. 2. Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. 3. Department of Internal Medicine I, Division of Endocrinology & Metabolism, Goethe University Hospital, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany. 4. Pediatric Endocrinology Division, Children's Hospital, University of Bonn, Adenauerallee 119, D-53113 Bonn, Germany. 5. Department of Pediatrics II, University Children's Hospital Essen, Hufelandstraße 55, D-45147 Essen, Germany. 6. Department of Internal Medicine II, Division of Endocrinology and Diabetology, University Hospital of Freiburg, Hugstetter Straße 49, D-79106 Freiburg, Germany. 7. Department of Pediatrics, University of Bochum, Alexandrinenstraße 5, D-44791 Bochum, Germany. 8. Department of Pediatrics I, Medical University of Innsbruck, Christoph Probst Platz 1, A-6020 Innsbruck, Austria. 9. 3rd Medical Department, Hospital Hietzing, Wolkersbergenstraße 1, A-1130 Vienna, Austria. 10. Department of Pediatrics, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany. 11. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, D-89081 Ulm, Germany.
Abstract
BACKGROUND: In Germany/Austria, data on medical care for cystic fibrosis-related diabetes (CFRD) is limited. METHODS: Anonymized data from 659 CFRD patients were analyzed and compared to the latest ADA/CFF guidelines. RESULTS: Specialized diabetes clinics were attended less frequently than recommended (3.1 vs. 4.0 times yearly). 7.9% of patients had a complete profile of examinations: diabetes education (44.9%), HbA1c (88.8%), blood pressure (79.5%), BMI (86.5%), lipid status (37.5%), retinopathy (29.9%), microalbuminuria (33.2%), and self-monitoring of blood glucose (71.6%). HbA1c and blood pressure were measured less frequently than recommended (2.3 and 2.0 vs. 4.0 times yearly). Overall, guidelines were followed more frequently in children than adults. Contrary to recommendations, not all patients were treated with insulin (77.2 vs. 100.0%). Insulin therapy was initiated earlier in children than adults, but there was still a substantial delay (0.9 vs. 2.7years after diagnosis, p<0.001). CONCLUSION: In CFRD patients studied, adherence to care guidelines was suboptimal.
BACKGROUND: In Germany/Austria, data on medical care for cystic fibrosis-related diabetes (CFRD) is limited. METHODS: Anonymized data from 659 CFRD patients were analyzed and compared to the latest ADA/CFF guidelines. RESULTS: Specialized diabetes clinics were attended less frequently than recommended (3.1 vs. 4.0 times yearly). 7.9% of patients had a complete profile of examinations: diabetes education (44.9%), HbA1c (88.8%), blood pressure (79.5%), BMI (86.5%), lipid status (37.5%), retinopathy (29.9%), microalbuminuria (33.2%), and self-monitoring of blood glucose (71.6%). HbA1c and blood pressure were measured less frequently than recommended (2.3 and 2.0 vs. 4.0 times yearly). Overall, guidelines were followed more frequently in children than adults. Contrary to recommendations, not all patients were treated with insulin (77.2 vs. 100.0%). Insulin therapy was initiated earlier in children than adults, but there was still a substantial delay (0.9 vs. 2.7years after diagnosis, p<0.001). CONCLUSION: In CFRD patients studied, adherence to care guidelines was suboptimal.
Authors: Angel Li; Tim Vigers; Laura Pyle; Edith Zemanick; Kristen Nadeau; Scott D Sagel; Christine L Chan Journal: J Cyst Fibros Date: 2018-08-10 Impact factor: 5.482
Authors: Barbara Bohn; Christof Schöfl; Vincent Zimmer; Michael Hummel; Nikolai Heise; Erhard Siegel; Wolfram Karges; Michaela Riedl; Reinhard W Holl Journal: Cardiovasc Diabetol Date: 2016-05-03 Impact factor: 9.951