Screening for cystic fibrosis-related diabetes: a systematic review.

Abstract

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HbA1c as a screening tool for cystic fibrosis related diabetes

“…Screening for CFRD is important as highlighted by a recent systematic review [14]. The use of HbA1c to diagnose type 1 and 2 diabetes has recently been introduced (≥ 6.5% (48 mmol/mol) = diabetes) by the American Diabetic Association [18] and so translating this to CFRD may be logical although this is heavily debated.…”

“…Receiver operating curves (ROC) were constructed to determine the optimal threshold for the selected criteria. As no recommendations exist for acceptable test screening sensitivity and specificity for CFRD, our aim was to produce a diabetes screening tool with excellent sensitivity (N 95% -to minimise the risk of missing a patient with a positive OGTT) and acceptable specificity (to reduce the need for a routine OGTT as much as possible) as it is well recognised that a higher sensitivity can usually only be achieved at the cost of poorer specificity [14]. From the final screening criteria, we explored the relationship of the measured clinical characteristics and the probability of a positive screen outcome.…”

Standards of Medical Care in Diabetes—2014

“…Genetically determined function of the remaining b-cells and insulin resistance associated with infection and inflammation may also play a role. Encouraging data suggest that improved screening (544,545) and aggressive insulin therapy have narrowed the gap in mortality between cystic fibrosis patients with and without diabetes, and have eliminated the sex difference in mortality (546). Recent trials comparing insulin with oral repaglinide showed no significant difference between the groups.…”

Nutritional status in patients with cystic fi brosis before and after lung transplantation

“…Частота развития сахарного диабета у пациентов, страдающих МВ, увеличивается с возрастом (более 50% больных старше 40 лет) [14]. Гипергликемия способствует бактериальной колонизации легких, усугубляя нарушения функции респираторной системы, увеличивая риск развития неблагоприятного исхода [15]. С целью своевременного выявления сахарного диабета проводят ежегодный скрининг толерантности к глюкозе среди пациентов с МВ с 10-летнего возраста [16].…”

“…Таким образом, восстановление нормальных значений ИМТ (18,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)9 ОБЗОРНЫЕ СТАТЬИ И ЛЕКЦИИ…”