265 Complications of diabetes in an adolescent Cystic Fibrosis population

Abstract

Introduction: Cystic fibrosis related diabetes (CFRD) is increasing. We aim to determine HbA1C ranges and incidence of complications in CFRD pts when age/sex matched to non-CF diabetic controls. Methods: 11 CFRD patients (mean age 23.5 SE 1.49, 7M/4F) were age/sex matched to non-CF, type I diabetics (mean age 23.6 SE 1.52, 7M/4F). The HbA1C range (over 3 y), length from dx and all complications of DM recorded. Results: CFRD had comparable ranges of HbA1C than age/sex matched controls (range 4.8 15.1%, mean 7.90% SE 0.41, and 5.0 14.6%, mean 8.73% SE 0.41, respectively) [p-value 0.05]. Duration of DM differed b/w the gps; CFRD (mean 3.56 yrs/median 3 yrs) and non-CF diabetics (mean 9.61 yrs/median 8 yrs) [p-value <0.05]. Both groups experienced hypoand hyperglycemia. Only the control group (n 2, 18.1%) experienced microvascular complications. Neither group had macrovascular complications. DKAs were isolated to the control group; 45.0% (n 5). One CFRD had steroid induced diabetes, and one control patient developed autoimmune hypothyroidism. Other complications included recurrent urinary tract (n 3) and fungal nail infections (n 1). Conclusions: CFRD are similarly controlled compared to age/sex matched counterparts reflected by HbA1C levels. Poorer nutritional status in CF can explain differing mean HbA1C levels. Absence of microvascular complications in CFRD reflects later onset/shorter duration of DM. Both groups receive insulin, and the absence of DKAs among CFRD suggests presence of residual endogenous insulin secretion. Although HbA1C is regularly used to monitor glycaemic control in both groups, it must not be used for diabetic screening. A formal OGTT carried out regularly (yearly after age 10) is the gold standard for a diagnosis of DM in all CF patients. 7. Metabolic complications of CF