MON-LB011 Retrospective Comparison of Cystic Fibrosis Related Diabetes Pediatric Screening Rates

Abstract

Cystic fibrosis-related diabetes (CFRD) is the most common comorbidity in those with CF, affecting 20% of adolescents and 40-50% of adults with CF. If uncontrolled, it can cause worsened pulmonary outcomes, increased hospital length of stay, and increased mortality. It is typically clinically silent, and hemoglobin A1C and fasting plasma glucose are not sensitive enough to diagnose it. Per national guidelines, the proper outpatient screening method is oral glucose tolerance test (OGTT), annually beginning age 10. Inpatient diagnosis involves fasting glucose >126 mg/dl or 2 hour postprandial glucose >200 persisting for more than 48 hours. It is believed that national screening guidelines are unfortunately not being met, particularly while inpatient. At our institution, there are 137 pediatric patients with CF; of those, 8 have a diagnosis of CFRD, and 4 have impaired glucose tolerance.We aim to study the adherence of our institution to the best practice guidelines for CFRD screening in pediatric patients with Cystic Fibrosis.Retrospective chart review is occurring through our institution’s EMR for inpatient data, and through a CF database (PortCF) for outpatient data. Inclusion criteria includes pediatric patients (below 1 day or above 17 years and 364 days) with CF. Exclusion criteria is those outside this age range, and those with CFRD. Consent is waived, as this is a retrospective data collection. Several variables including demographics, glycemic status, CFTR modulator and class, corticosteroid and vitamin use, and feeding regimen are also being reviewed. REDCap is being used for secure data entry and analysis. Descriptive statistical analysis will be used. Categorical data will be expressed as frequency (percent). Numeric data will be expressed as mean ± standard deviation or median [25th, 75th percentile], depending on normality of the data. Univariate analysis, like Chi square or Fisher’s exact test, will be used between successful and unsuccessful inpatient screens for CFRD.Thus far, retrospective chart review of all outpatient data is complete. Preliminary analysis of those who should have received OGTT screening shows 11% have never been screened, and 32% were screened more than one year ago. Completion of inpatient data collection and all statistical analysis is anticipated within the next month. Future direction includes increasing inpatient CFRD screening with use of continuous glucose monitoring sensors during CF exacerbation admissions.