Background:
Cystic Fibrosis (CF) is a life limiting recessive genetic disease. Patients with CF are living longer than in previous decades. The result of this is that adult related CF complications are now developing.
CFRD is the most common non-respiratory complication in adults with CF.
Patients with CFRD for over five years are at risk of microvascular diabetes related complications.
This project is looking to see if diabetes complications assessments are being performed routinely.
Current Practice:
When patients with CF at our centre currently undergo routine CF reviews, diabetes management is discussed. If hyperglycaemia is of more than five years duration annual review assessments are instigated. This identification is carried out on a case by case ad hoc basis but is not flagged to be done routinely.
Mater CF registry of 115 was examined and potential participants identified 115 → 35
Pathology results and correspondence were searched, looking for the duration of CFRD which was often unclear and not listed on registry
Sample:
35 with significant glucose abnormality
10 met inclusion criteria
1 participant deceased before Audit 1 completed
Final sample→ N=9
An annual diabetes review includes, pathology, eye review, ACR, foot assessment and BP measurement. In CFRD pathology is routinely taken already, so only the other checks need attending.
Findings: The only patients who had all screening attended were seen by private endocrinologist.
Screenings were difficult to complete outside of a dedicated CF appointment despite reminders.
Identification of sample population would have been made easier with diabetes diagnosis date noted on registry.
Conclusions:
Only 55% of diabetes complications assessments were attended by project end.
CFRD diagnosis date needs to be added to registry.
Complications reviews need to be attended at routine attendances.