SAT-643 Predictors of Technology Success in Cystic Fibrosis Related Diabetes

Abstract

Background: As patients with cystic fibrosis live longer, cystic fibrosis related diabetes (CFRD) is becoming a more common complication. CFRD has a negative impact on lung function, nutrition, and survival. The ADA guidelines recommend that patients with CFRD be treated with insulin and monitor their glucose at least three times a day. Continuous glucose monitors (CGM) allow glucose to be measured by scanning a reading device or by automatic updates every 5 minutes. Little is known about factors predicting successful CGM use in patients with CFRD.Methods: We completed a retrospective chart review of all patients with insulin-treated CFRD at a single center. Successful CGM implementation was defined as CGM use for 3 months or more. Patient characteristics (age, BMI, ppFEV1, HbA1C, diabetes duration, insurance type) were compared between the CGM and no CGM groups. For the CGM group, HbA1C, ppFEV1, and BMI, were compared before and after CGM implementation. Paired and unpaired t-tests were used to evaluate continuous variables and fisher’s exact test was used to evaluate dichotomous variables.Results: Of the 55 patients eligible for inclusion, 12 patients (22%) had successfully implemented CGM in their diabetes routine. Age, BMI, ppFEV1, HbA1C, and insurance type were not significantly different between the CGM and no CGM groups. CGM users appeared to have a slightly longer duration of diabetes than non-implementers but this did not meet statistical significance (6.6 vs. 4.8 years, p=0.08). Among CGM users, BMI, ppFEV1, and hemoglobin A1C did not change significantly after implementation of CGM. The documented number of glucose checks did increase at the CFRD visit immediately after implementing CGM (1.9 vs. 3.3 checks per day, p=0.002).Conclusions: No patient factor was found to predict successful CGM implementation in our cohort. Our small study suggests that longer duration of diabetes may be associated with successful CGM implementation. Longer follow-up is needed to determine whether CGM therapy improves A1C, BMI, or ppFEV1 in patients with insulin-treated CFRD.