Microvascular complications in cystic fibrosis-related diabetes.
OBJECTIVE
The incidence of cystic fibrosis-related diabetes (CFRD) and the prevalence of diabetic microvascular complications were determined at the University of Minnesota.


METHODS
Cystic fibrosis patients have undergone annual oral glucose tolerance testing since 1990. Database review was performed to determine diabetes duration and the results of annual urine albumin-to-creatinine ratio (U(alb:Cr)) screening and dilated retinal exams. In addition, 59 individuals underwent detailed retinopathy, nephropathy, neuropathy, and gastroenteropathy screening.


RESULTS
During 1990-2005, 775 patients aged > or = 6 years were followed. CFRD was diagnosed by an oral glucose tolerance test or fasting hyperglycemia in 285 subjects (52% female), 64% of whom had fasting hyperglycemia. Most patients with CFRD without fasting hyperglycemia progressed to CFRD with fasting hyperglycemia over time. No subject with CFRD without fasting hyperglycemia had retinopathy or abnormal U(alb:Cr). In CFRD subjects with fasting hyperglycemia and diabetes for > or = 10 years, 14% had microalbuminuria and 16% had retinopathy. Autonomic neuropathy and gastrointestinal symptoms each were seen in 52% and somatic abnormalities in 22% of patients with or without fasting hyperglycemia.


CONCLUSIONS
Diabetic microvascular complications occur in CFRD, although the prevalence of retinopathy and nephropathy appears to be less than that found in other forms of diabetes. Annual complication screening should occur after known diabetes duration of 5 years in patients with CFRD with fasting hyperglycemia.
Schwarzenberg
Sarah Jane
SJ
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55454, USA.
Thomas
William
W
Olsen
Timothy W
TW
Grover
Trish
T
Walk
David
D
Milla
Carlos
C
Moran
Antoinette
A
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000150:complications*; D016208:Databases, Factual; D048909:Diabetes Complications / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D008297:Male; D008833:Microcirculation; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology*