Clinical practice versus guidelines for the screening of cystic fibrosis-related diabetes: A French survey from the 47 centers

Laurence Weiss; Olivia Ronsin; Quitterie Reynaud; Michel Abely; Laurent Mely; Pierre-Régis Burgel; Jacques Beltrand; Laurence Kessler

doi:10.1016/j.jcte.2022.100298

Clinical practice versus guidelines for the screening of cystic fibrosis-related diabetes: A French survey from the 47 centers

J Clin Transl Endocrinol. 2022 Apr 4:28:100298. doi: 10.1016/j.jcte.2022.100298. eCollection 2022 Jun.

Authors

Laurence Weiss¹, Olivia Ronsin², Quitterie Reynaud³, Michel Abely⁴, Laurent Mely⁵, Pierre-Régis Burgel^{6

7}, Jacques Beltrand^{8

9}, Laurence Kessler^{10

11}

Affiliations

¹ Pediatric Cystic Fibrosis Center, University Hospital of Strasbourg, France.
² Adult Cystic Fibrosis Center, University Hospital Timone, Marseille, France.
³ Adult Cystic Fibrosis Center, Department of Internal Medicine Hospices Civils Lyon, France.
⁴ Pediatric Cystic Fibrosis Center, American Memorial Hospital, Reims, France.
⁵ Cystic Fibrosis Center, Renée Sabran Hospital, Giens, France.
⁶ Respiratory Medicine and Cystic Fibrosis National Reference Center, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
⁷ Université de Paris, Institut Cochin, Inserm U1016, Paris, France.
⁸ Pediatric Endocrinology, Gynecology and Diabetes, Hôpital Necker Enfants-Malades, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France.
⁹ Inserm U1016, Institut Cochin, Paris, France.
¹⁰ Department of Diabetology, Adult Cystic Fibrosis Center, University Hospital Strasbourg, France.
¹¹ Inserm UMR 1260, Regenerative Nanomedicine, University of Strasbourg, France.

Abstract

This study aimed to analyze clinical practices concerning cystic fibrosis-related diabetes (CFRD) screening in France. A web-based questionnaire was distributed between December 1, 2020 and January 31, 2021 among 47 cystic fibrosis centers including pediatric, adult, and mixed units. In accordance with guidelines, 92.8% of CF centers performed annual oral glucose tolerance tests (OGTT). Overall, 86.3% of CF centers performed 1- and 2-hour blood glucose determinations following OGTT. The OGTT was conducted before 10 years of age in 73% of pediatric centers. Continuous glucose monitoring (CGM) and laboratory glycated hemoglobin were employed for CFRD screening in 86.5% and 50% of centers, respectively. CGM was carried out in 69% of centers after glucose tolerance abnormalities had been detected in OGTT. Most CF centers used OGTT and CGM for CFRD screening. Studies are required to assess CGM usefulness as a validated tool in CFRD screening.

Keywords: Continuous glucose monitoring; Cystic fibrosis; Diabetes; OGTT; Screening.