Comparison of cystic fibrosis-related diabetes with type 1 diabetes based on a German/Austrian Pediatric Diabetes Registry.

Abstract

OBJECTIVE:

The prevalence of cystic fibrosis-related diabetes (CFRD) has increased with improved life expectancy of patients. Clinical and care characteristics were compared with type 1 diabetes mellitus (T1DM) in a multicenter analysis of pediatric data.

RESEARCH DESIGN AND METHODS:

Auxological and treatment data from 47,227 patients aged younger than 21 years with CFRD or T1DM in the German/Austrian Diabetes Prospective Documentation Initiative registry were analyzed by multivariable mixed regression modeling.

RESULTS:

Diabetes onset (mean [interquartile range]) occurred later in individuals with CFRD (14.5 [11.8-16.3] years) than in individuals with T1DM (8.5 [4.9-11.8] years), with female preponderance in CFRD (59.1% vs. 47.5%; P < 0.01). CFRD patients had lower BMI standard deviation scores (-0.85 [-1.59 to -0.12] vs. +0.52 [-0.10 to +1.16]; P < 0.01) and lower HbA(1c) (6.87% vs. 7.97%; P < 0.01). Self-monitoring of blood glucose was more frequent in patients with T1DM (4.5 vs. 3.5; P < 0.01); 72% of CFRD patients received insulin. In insulin-treated patients, insulin dosage adjusted for age, sex, and diabetes duration differed significantly (T1DM: 0.79 IE per kilogram of body weight; CFRD: 0.83 IE per kilogram of body weight). Use of short-acting and long-acting insulin analogs was significantly more frequent in T1DM (47% vs. 39% and 37% vs. 28%; both P < 0.05). Metabolic control in CFRD patients without insulin was better compared with CFRD on insulin (HbA(1c): 6.00 vs. 7.12; P < 0.01), but duration of disease was significantly shorter (0.8 years [0.1-2.4] compared with 2.4 years [0.6-4.6]). There was no significant difference for BMI standard deviations scores between CFRD patients with or without insulin treatment.

CONCLUSIONS:

Pediatric patients with CFRD show clear auxological and metabolic differences from those with T1DM, with different treatment choices.

• Authors: Katja Konrad, Angelika Thon, Maria Fritsch, Elke Fröhlich-Reiterer, Eggert Lilienthal, Stefan A Wudy, Reinhard W Holl, German/Austrian Diabetes Prospective Documentation Initiative
• Journal: Diabetes care (Diabetes Care) Vol. 36 Issue 4 Pg. 879-86 (Apr 2013) ISSN: 1935-5548 [Electronic] United States
• PMID: 23238661 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hypoglycemic Agents
• Insulin

Topics

• Adolescent
• Child
• Child, Preschool
• Cystic Fibrosis (drug therapy, epidemiology)
• Diabetes Mellitus, Type 1 (drug therapy, epidemiology)
• Female
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insulin (therapeutic use)
• Male
• Registries