Increased detection of cystic-fibrosis-related diabetes in Australia
- Malay Rana1,2,
- Craig F Munns1,3,
- Hiran C Selvadurai3,4,
- Sharon Simonds4,
- Peter J Cooper3,4,
- Helen J Woodhead2,5,6,
- Shihab Hameed2,5,
- Charles F Verge2,5,
- Antony R Lafferty7,8,
- Patricia A Crock9,
- Maria E Craig1,2,3
- 1Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- 2School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
- 3Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
- 4Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- 5Department of Endocrinology, Sydney Children's Hospital Randwick, Sydney, New South Wales, Australia
- 6Department of Paediatrics, Campbelltown Hospital, Sydney, New South Wales, Australia
- 7Department of Endocrinology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
- 8Department of Paediatrics and Child Health, Australian National University Medical School, Canberra, Australian Capital Territory, Australia
- 9Department of Endocrinology, John Hunter Children's Hospital, Newcastle, New South Wales, Australia
- Correspondence to Associate Professor Maria E Craig, Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145 NSW, Australia;
- Accepted 28 April 2011
- Published Online First 8 June 2011
Objectives To estimate the incidence of cystic-fibrosis-related diabetes (CFRD) in youth from New South Wales (NSW) and the Australian Capital Territory (ACT), Australia and to examine demographic/clinical features at diagnosis.
Methods Incident cases of CFRD in young people aged ≤18 years diagnosed during 2000 to 2008 were identified from four paediatric cystic fibrosis (CF) clinics and the NSW/ACT Australasian Paediatric Endocrine Group Diabetes Register.
Results CFRD was diagnosed in 41 cases (59% girls). The estimated mean annual incidence of CFRD among patients with CF was 9.4 per 1000 person years (95% CI 6.8 to 12.8). Incidence increased from 2.0 per 1000 person years in 2000 to 22.1 per 1000 in 2008 (incidence RR 1.3, 95% CI 1.1 to 1.4). Haemoglobin A1c (HbA1c) was abnormal in the majority at diagnosis: median HbA1c was 6.9% (6.2–8.1%). More cases were diagnosed using an oral glucose tolerance test in 2007–2008 compared with previous years (61% vs 6%, p<0.001).
Conclusions CFRD is increasingly recognised and now affects approximately one in five young people with CF. The rising incidence is likely to be due to increased detection, resulting from greater awareness and changes in screening practices. Widespread uptake of consensus guidelines for screening will ensure accurate case detection, but will also impact on patient care and resource allocation.
Competing interests None.
Ethics approval This study was conducted with the approval obtained from all participating centres.
Provenance and peer review Not commissioned; externally peer reviewed.