Australian standards of care for cystic fibrosis‐related diabetes

Abstract

Multiple guidelines have been published over the last few years for the diagnosis and management of cystic fibrosis (CF) and cystic fibrosis related diabetes (CFRD), although some of the recommendations are based on extrapolation from other forms of diabetes and/or expert opinions. This document seeks to combine the guidelines to provide an Australian approach to the management of CFRD and establish the guidelines within the Australian CF Standards of Care. It is intended that this document will provide assistance to doctors, nurses, dietitians, physiotherapists, diabetes educators and CF patients concerning the issues surrounding CFRD, and will be reviewed and updated in 2016.

High prevalence of diabetes before and after lung transplantation: target for improving outcome?

“…6 CFRD is a late event and is preceded by more subtle glucose abnormalities on OGTT, with peak glucose ≥8.2 mmol/L at 60 and 90 min associated with reduced weight and lung function in the preceding 12 months. 9 There was 100% progression in all seven transplanted patients with CFRH to diabetes post-transplantation. 9 There was 100% progression in all seven transplanted patients with CFRH to diabetes post-transplantation.…”

“…8,13 CFRD is associated with increased mortality. 9,14 Additionally, because the mean age of our CF cohort was 30.4 AE 15.3 years, patients in our study were more likely to have developed CF-related comorbidities. 9,14 Additionally, because the mean age of our CF cohort was 30.4 AE 15.3 years, patients in our study were more likely to have developed CF-related comorbidities.…”

“…6 It has been shown that in patients with CF, even 'mild' abnormal glucose levels (blood glucose peak ≥8.2 mmol/L at 60 or 90 min on OGTT) are associated with lower bodyweight and impaired lung function in the preceding 12 months. [8][9][10] The aim of this study was to determine the prevalence of diagnosed and undiagnosed diabetes in patients actively wait-listed for, or having had, lung transplantation at a state-wide quaternary referral service for lung transplantation. 7 It has been proposed by Hameed et al.…”

The Icet-a Recommendations for the Diagnosis and Management of Disturbances of Glucose Homeostasis in Thalassemia Major Patients

“…Therefore, those who are contemplating pregnancy should be evaluated prior to conception to rule out any impairment of glucose homeostasis. Specific criteria for the diagnosis of gestational diabetes should be used 92,93…”

Nutritional management of cystic fibrosis and cystic fibrosis‐related diabetes in Australia

“…Following best practice guidelines ensures that patients with CF receive evidence‐based and consistent nutritional management from dietitians. Currently, there is a lack of data on the consistency of dietetic management between Australian CF centres, with little to no information on whether dietetic services are being delivered in accordance with national evidence‐based guidelines . The most recent surveys of Australian dietetic practice in CF were last undertaken in 1996 and 2005, and included only minimal information on the management of CFRD.…”