Adherence to clinical care guidelines for cystic fibrosis-related diabetes in 659 German/Austrian patients

Nicole Scheuing; Gabriele Berger; Dominik Bergis; Bettina Gohlke; Katja Konrad; Katharina Laubner; Eggert Lilienthal; Christine Moser; Ingrid Schütz-Fuhrmann; Angelika Thon; Reinhard W Holl; German/Austrian Diabetes Prospective Documentation (DPV) Initiative

doi:10.1016/j.jcf.2014.05.006

Adherence to clinical care guidelines for cystic fibrosis-related diabetes in 659 German/Austrian patients

J Cyst Fibros. 2014 Dec;13(6):730-6. doi: 10.1016/j.jcf.2014.05.006. Epub 2014 Jun 7.

Affiliations

¹ Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, D-89081 Ulm, Germany. Electronic address: [email protected].
² Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
³ Department of Internal Medicine I, Division of Endocrinology & Metabolism, Goethe University Hospital, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany.
⁴ Pediatric Endocrinology Division, Children's Hospital, University of Bonn, Adenauerallee 119, D-53113 Bonn, Germany.
⁵ Department of Pediatrics II, University Children's Hospital Essen, Hufelandstraße 55, D-45147 Essen, Germany.
⁶ Department of Internal Medicine II, Division of Endocrinology and Diabetology, University Hospital of Freiburg, Hugstetter Straße 49, D-79106 Freiburg, Germany.
⁷ Department of Pediatrics, University of Bochum, Alexandrinenstraße 5, D-44791 Bochum, Germany.
⁸ Department of Pediatrics I, Medical University of Innsbruck, Christoph Probst Platz 1, A-6020 Innsbruck, Austria.
⁹ 3rd Medical Department, Hospital Hietzing, Wolkersbergenstraße 1, A-1130 Vienna, Austria.
¹⁰ Department of Pediatrics, Hannover Medical School, Carl-Neuberg-Straße 1, D-30625 Hannover, Germany.
¹¹ Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, D-89081 Ulm, Germany.

PMID: 24917115
DOI: 10.1016/j.jcf.2014.05.006

Abstract

Background: In Germany/Austria, data on medical care for cystic fibrosis-related diabetes (CFRD) is limited.

Methods: Anonymized data from 659 CFRD patients were analyzed and compared to the latest ADA/CFF guidelines.

Results: Specialized diabetes clinics were attended less frequently than recommended (3.1 vs. 4.0 times yearly). 7.9% of patients had a complete profile of examinations: diabetes education (44.9%), HbA1c (88.8%), blood pressure (79.5%), BMI (86.5%), lipid status (37.5%), retinopathy (29.9%), microalbuminuria (33.2%), and self-monitoring of blood glucose (71.6%). HbA1c and blood pressure were measured less frequently than recommended (2.3 and 2.0 vs. 4.0 times yearly). Overall, guidelines were followed more frequently in children than adults. Contrary to recommendations, not all patients were treated with insulin (77.2 vs. 100.0%). Insulin therapy was initiated earlier in children than adults, but there was still a substantial delay (0.9 vs. 2.7years after diagnosis, p<0.001).

Conclusion: In CFRD patients studied, adherence to care guidelines was suboptimal.

Keywords: Anti-hyperglycemic therapy; Cystic fibrosis-related diabetes; Guideline recommendations; Insulin treatment; Medical care; Nutritional status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Austria
Child
Cystic Fibrosis / complications*
Cystic Fibrosis / therapy*
Diabetes Complications / etiology
Diabetes Complications / therapy*
Female
Germany
Glycated Hemoglobin
Guideline Adherence*
Humans
Hypoglycemic Agents / therapeutic use
Male
Nutrition Assessment
Practice Guidelines as Topic
Registries
Retrospective Studies
Young Adult

Substances

Glycated Hemoglobin A
Hypoglycemic Agents