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Cystic fibrosis‐related diabetes compared with type 1 and type 2 diabetes in adults
Author(s) -
Konrad Katja,
Scheuing Nicole,
Badenhoop Klaus,
Borkenstein Martin H.,
Gohlke Bettina,
Schöfl Christof,
Seufert Jochen,
Thon Angelika,
Holl Reinhard W.
Publication year - 2013
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2429
Subject(s) - cystic fibrosis related diabetes , medicine , cystic fibrosis , diabetes mellitus , type 1 diabetes , interquartile range , gastroenterology , body mass index , type 2 diabetes , endocrinology , impaired glucose tolerance
Background With increasing life expectancy of patients with cystic fibrosis (CF), secondary diabetes becomes more prevalent. It appears to be the most common co‐morbidity in persons with cystic fibrosis. Therefore, the objective of our study was to describe characteristics of cystic fibrosis‐related diabetes compared with type 1 and 2 diabetes (T1DM/T2DM) in adults. Methods Data from 218 436 patients >18 years with cystic fibrosis ( n = 401), T1DM ( n = 32,409) or T2DM ( n = 185 626) in the multicenter Diabetes‐Patienten‐Verlaufsdokumentation or prospective documentation of diabetes patients registry were analysed. Results Diabetes onset [median (interquartile range)] in cystic fibrosis [18.70 (15.50–25.30) years] was between T1DM [16.40 (10.50–31.80) years] and T2DM [58.50 (48.80–68.00) years], with female preponderance. Body mass index (BMI) and glycosylated haemoglobin (HbA 1c ) were lowest (19.6 [18.1–21.5] kg/m 2 )/50 mmol/mol (6.73%) versus T1DM (24.4 [22.1–27.4])/62 mmol/mol (7.83%) vs . T2DM (29.6 [26.1–33.9])/54 mmol/mol (7.06%); all p < 0.01. A total of 78.6% of cystic fibrosis patients with diabetes received insulin. Insulin dose (0.74 IE/kg bodyweight) was not significantly different from T1DM (0.73) and T2DM (0.76). Frequency of vascular complications, adjusted for confounding effects, across the groups was different: Hypertension (CFRD 16.1% vs . T1DM 24.0% vs . T2DM 32.2%; all p < 0.01), retinopathy (CFRD 10.7% vs . T1DM 10.4% vs . T2DM 10.5%, not significant), nephropathy (CFRD 25.2% vs . T1DM 17.2% vs . T2DM 24.7%; only T1DM/T2DM; p < 0.01). Conclusion CFRD is a uniquely complex entity with clear differences from T1DM and T2DM in adults. Copyright © 2013 John Wiley & Sons, Ltd.