Elizabeth Franck Thompson1, David Watson2, Christine M Benoit2, Sandy Landvik3, John McNamara4. 1. Children's Minnesota, United States of America. Electronic address: thom2644@umn.edu. 2. Children's Minnesota, United States of America. 3. Children's Respiratory and Critical Care Specialists, P.A., United States of America. 4. Children's Minnesota, United States of America; Children's Respiratory and Critical Care Specialists, P.A., United States of America.
Abstract
BACKGROUND: Cystic fibrosis related diabetes (CFRD) has been associated with pulmonary function decline, nutritional status decline and increased mortality. In 2010, the CFRD Clinical Care Guideline were updated, recommending all patients with CF begin CFRD screening at 10 years old. This study uses CF Foundation Patient Registry to examine the impact of screening practices at centers across the United States from 2008 to 2015. We examined the association of screening practices and CFRD diagnosis at individual centers and trends in ppFEV1 and BMI percentile prior to and after diagnosis. METHODS: The cohort was defined as patients with CF and without CFRD who turned 10 years old from 2009 to 2015. Centers were classified based on their CFRD screening rates. Kaplan-Meier curves summarized the distribution of age at CFRD diagnosis. Among patients diagnosed with CFRD, we examined differences in ppFEV1 and BMI percentile two years prior to diagnosis and two years post-diagnosis by clinic screening rate. RESULTS: Of 3553 patients, 445 (13%) were diagnosed with CFRD. The average age of diagnosis was 13 years old. The screening rate of the patients' clinic was significantly associated with time to diagnosis (pvalue=0.0001). Among patients diagnosed with CFRD, clinics with lower screening rates of CFRD had steeper rates of pulmonary decline two years prior to diagnosis. CONCLUSION: Centers that screen for CFRD more tend to diagnose a larger percent of patients with CFRD and at a younger age. Additionally, patients at centers with lower screening rates have faster rates of pulmonary decline prior to CFRD diagnosis.
BACKGROUND: Cystic fibrosis related diabetes (CFRD) has been associated with pulmonary function decline, nutritional status decline and increased mortality. In 2010, the CFRD Clinical Care Guideline were updated, recommending all patients with CF begin CFRD screening at 10 years old. This study uses CF Foundation Patient Registry to examine the impact of screening practices at centers across the United States from 2008 to 2015. We examined the association of screening practices and CFRD diagnosis at individual centers and trends in ppFEV1 and BMI percentile prior to and after diagnosis. METHODS: The cohort was defined as patients with CF and without CFRD who turned 10 years old from 2009 to 2015. Centers were classified based on their CFRD screening rates. Kaplan-Meier curves summarized the distribution of age at CFRD diagnosis. Among patients diagnosed with CFRD, we examined differences in ppFEV1 and BMI percentile two years prior to diagnosis and two years post-diagnosis by clinic screening rate. RESULTS: Of 3553 patients, 445 (13%) were diagnosed with CFRD. The average age of diagnosis was 13 years old. The screening rate of the patients' clinic was significantly associated with time to diagnosis (pvalue=0.0001). Among patients diagnosed with CFRD, clinics with lower screening rates of CFRD had steeper rates of pulmonary decline two years prior to diagnosis. CONCLUSION: Centers that screen for CFRD more tend to diagnose a larger percent of patients with CFRD and at a younger age. Additionally, patients at centers with lower screening rates have faster rates of pulmonary decline prior to CFRD diagnosis.
Authors: Yu-Chung Lin; Katherine Keenan; Jiafen Gong; Naim Panjwani; Julie Avolio; Fan Lin; Damien Adam; Paula Barrett; Stéphanie Bégin; Yves Berthiaume; Lara Bilodeau; Candice Bjornson; Janna Brusky; Caroline Burgess; Mark Chilvers; Raquel Consunji-Araneta; Guillaume Côté-Maurais; Andrea Dale; Christine Donnelly; Lori Fairservice; Katie Griffin; Natalie Henderson; Angela Hillaby; Daniel Hughes; Shaikh Iqbal; Jennifer Itterman; Mary Jackson; Emma Karlsen; Lorna Kosteniuk; Lynda Lazosky; Winnie Leung; Valerie Levesque; Émilie Maille; Dimas Mateos-Corral; Vanessa McMahon; Mays Merjaneh; Nancy Morrison; Michael Parkins; Jennifer Pike; April Price; Bradley S Quon; Joe Reisman; Clare Smith; Mary Jane Smith; Nathalie Vadeboncoeur; Danny Veniott; Terry Viczko; Pearce Wilcox; Richard van Wylick; Garry Cutting; Elizabeth Tullis; Felix Ratjen; Johanna M Rommens; Lei Sun; Melinda Solomon; Anne L Stephenson; Emmanuelle Brochiero; Scott Blackman; Harriet Corvol; Lisa J Strug Journal: Genet Med Date: 2021-01-26 Impact factor: 8.822