Perceptions of Diabetes Technology Use in Cystic Fibrosis-Related Diabetes Management

Marks, Brynn E.; Kilberg, Marissa J; Aliaj, Enid; Fredkin, Kelsey; Hudson, Jessica; Riva, Dara; Roman, C.; Kelly, Andrea; Putman, Melissa S.

doi:10.1089/dia.2021.0201

Cited by 12 publications

(5 citation statements)

References 28 publications

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“…During the COVID-19 pandemic, most CF clinics utilized telemedicine to mitigate the risk of contracting COVID-19, resulting in challenges in performing blood tests to measure glucose and hemoglobin A1c (HbA1c) concentrations 4 . Although 75% of U.S. youth and adults with CFRD reported continuous glucose monitoring use 5 , there are some barriers including the cost of the device and supplies, insurance coverage, and complexity of the device 6 . Despite the increase in non-invasive glucose monitoring devices, more convenient methods of diagnosing and monitoring CFRD are necessary to prevent complications for adults with CF.…”

Section: Introductionmentioning

confidence: 99%

Predicting glycemic control status and high blood glucose levels through voice characteristic analysis in patients with cystic fibrosis-related diabetes (CFRD)

Suppakitjanusant,

Kasemkosin,

Sivapiromrat

et al. 2023

Sci Rep

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Cystic fibrosis-related diabetes (CFRD) is associated with reduced life expectancy in adults with cystic fibrosis (CF). Voice analysis may be a convenient method for diagnosing and monitoring CFRD. This study aims to determine the relationship between voice characteristics and markers of glucose and glycemic control and to identify if voice analysis can predict high blood glucose levels and glycemic control in adults with CFRD. We conducted a prospective cross-sectional study in adults with CF from March to December 2021. We recorded 3-second voice samples of a sustained /a/ vowel and analyzed voice characteristic using the Computerized Speech Lab with the Multi-Dimensional Voice Program. In female participants with CFRD, the noise-to-harmonic ratio was significantly lower in those with HbA1c ≥ 7. Furthermore, fundamental frequency variation was significantly lower in both male and female participants with CFRD who had a glucose level of 200 mg/dL or higher at the time of collection. This finding was also associated with a high level of point-of-care glucose. The human voice has potential as a non-invasive tool for measuring glucose levels and glycemic control status in CFRD patients in the future.

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Section: Introductionmentioning

confidence: 99%

Predicting glycemic control status and high blood glucose levels through voice characteristic analysis in patients with cystic fibrosis-related diabetes (CFRD)

Suppakitjanusant,

Kasemkosin,

Sivapiromrat

et al. 2023

Sci Rep

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“…Despite perceived benefits, the use of diabetes technology in people with Cystic Fibrosis is still low and related patients’ perception is still understudied. In a 2021 survey of CFRD patients in the United States, 75% of youth and adults reported CGM use, similar to T1DM patients, while only 29% reported insulin pump use ( 38 ). A significant benefit from CGM use was reported, but also a greater burden from insulin pump use.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of advanced hybrid closed loop systems in cystic fibrosis related diabetes: a pilot study

Bassi,

Franzone,

Dufour

et al. 2024

Front. Endocrinol.

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Background and aimsCystic fibrosis related diabetes (CFRD) is correlated with worsening of nutritional status and greater deterioration of lung function. The role of new technologies for the treatment of CFRD is little explored. The aim of the study was to evaluate the efficacy of Advanced Hybrid Closed Loop (AHCL) systems on glycemic control in CF patients.MethodsA single-center retrospective study on CFRD patients using AHCL systems was performed. Glycated hemoglobin (HbA1c) values and Continuous Glucose Monitoring (CGM) metrics were collected at T0 (AHCL placement), T1 (1-month), T2 (6-months) and T3 (1-year) to evaluate glycemic control.Results10 patients were included in the study. Data showed a reduction of HbA1c value (7.31 ± 0.34 to 6.35 ± 1.00; p=0.03), glycemic variability (p=0.05) and insulin requirement (p=0.03). The study population reached American Diabetes Association (ADA) recommended glycemic targets at 1-year. An increase in the Time in Range (TIR) and a reduction in time in hyperglycemia were also observed, although not statistically significant.ConclusionsIn patients with CFRD, the use of AHCL leads to an improvement in glycemic control in terms of HbA1c and glycemic variability. The increase in TIR and the reduction of time in hyperglycemia, although not statistically significant, are extremely encouraging from a clinical point of view. Further studies with a larger population and a longer follow-up are needed. The results of this study demonstrate the importance of proposing the use of AHCL even in CF patients, who could benefit from glycemic improvement also in terms of nutritional status and respiratory function.

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“…Recent advances in diabetes technology have shown promise in improving glycemic control and quality of life in people with type 1 diabetes ( 99 – 111 ), but studies are limited in CFRD. A recent survey of adults with CFRD and parents of children with CFRD suggested that sustained use of diabetes technology, including CGM and insulin pumps, was low and that strategies are needed to improve insurance coverage and patient education along with research to confirm efficacy and acceptability ( 112 ). Although CGM-guided insulin initiation was associated with slowing of the annual rate of pulmonary decline over 12 months ( 113 ), no published studies have investigated the effect of CGM on glycemic control or quality of life in people with CFRD managed with insulin.…”

Section: Current Gaps In Cfrd Care and Use Of Novel Treatment Approac...mentioning

confidence: 99%

Cystic Fibrosis–Related Diabetes Workshop: Research Priorities Spanning Disease Pathophysiology, Diagnosis, and Outcomes

et al. 2023

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Cystic fibrosis (CF) is a recessive disorder arising from mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. CFTR is expressed in numerous tissues, with high expression in the airways, small and large intestine, pancreatic and hepatobiliary ducts, and male reproductive tract. CFTR loss in these tissues disrupts regulation of salt, bicarbonate, and water balance across their epithelia, resulting in a systemic disorder with progressive organ dysfunction and damage. Pancreatic exocrine damage ultimately manifests as pancreatic exocrine insufficiency that begins as early as infancy. Pancreatic remodeling accompanies this early damage, during which abnormal glucose tolerance can be observed in toddlers. With increasing age, however, insulin secretion defects progress such that CF-related diabetes (CFRD) occurs in 20% of teens and up to half of adults with CF. The relevance of CFRD is highlighted by its association with increased morbidity, mortality, and patient burden. While clinical research on CFRD has greatly assisted in the care of individuals with CFRD, key knowledge gaps on CFRD pathogenesis remain. Furthermore, the wide use of CFTR modulators to restore CFTR activity is changing the CFRD clinical landscape and the field’s understanding of CFRD pathogenesis. For these reasons, the National Institute of Diabetes and Digestive and Kidney Diseases and the Cystic Fibrosis Foundation sponsored a CFRD Scientific Workshop, 23–25 June 2021, to define knowledge gaps and needed research areas. This article describes the findings from this workshop and plots a path for CFRD research that is needed over the next decade.

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Perceptions of Diabetes Technology Use in Cystic Fibrosis-Related Diabetes Management

Cited by 12 publications

References 28 publications

Predicting glycemic control status and high blood glucose levels through voice characteristic analysis in patients with cystic fibrosis-related diabetes (CFRD)

Predicting glycemic control status and high blood glucose levels through voice characteristic analysis in patients with cystic fibrosis-related diabetes (CFRD)

Efficacy of advanced hybrid closed loop systems in cystic fibrosis related diabetes: a pilot study

Cystic Fibrosis–Related Diabetes Workshop: Research Priorities Spanning Disease Pathophysiology, Diagnosis, and Outcomes

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