title: The screening and diagnosis of cystic fibrosis-related diabetes in the United Kingdom.
abstract: BACKGROUND
  The cystic fibrosis-related diabetes (CFRD) guidelines produced by the UK CF Trust differ from those used in Europe and the US. We conducted a study to establish current practice.
  
  
  METHODS
  Paediatric and adult questionnaires were devised and emailed to the 48 specialist UK CF centres.
  
  
  RESULTS
  Completed questionnaires were returned by 39/48 (81%) centres. Only 3/21 (14%) paediatric centres begin annual screening at 12 years (as per UK guidelines), 11/21 (52%) start to screen at 10 years (as per European and US guidelines) and 5/21 (24%) begin screening at a child's first annual review. The oral glucose tolerance test is used as a screening test in 33/39 (85%) of centres but only 3/33 (9%) use it in isolation. Home glucose monitoring is the most frequently used diagnostic test undertaken in 32/39 (82%) centres, and again this is rarely used in isolation. The decision to initiate insulin is often shared between specialist nurses and doctors.
  
  
  CONCLUSIONS
  In the UK the majority of CF centres use the OGTT to screen and HGM to diagnose CFRD. The use of other tools varies with poor adherence to UK guidelines. These 2004 guidelines would benefit from being updated to reflect current best evidence.
authors: Academic Department of Child Health, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent ST4 6QG, UK.
authors: Kate L
authors: KL
authors: Wickens-Mitchell
authors: Academic Department of Child Health, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent ST4 6QG, UK; Institute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Thornburrow Drive, Stoke-on-Trent ST4 7QB, UK.
authors: Francis J
authors: FJ
authors: Gilchrist
authors: Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK.
authors: D
authors: D
authors: McKenna
authors: Academic Department of Child Health, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent ST4 6QG, UK.
authors: P
authors: P
authors: Raffeeq
authors: Academic Department of Child Health, University Hospital of North Staffordshire, Newcastle Road, Stoke-on-Trent ST4 6QG, UK; Institute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Thornburrow Drive, Stoke-on-Trent ST4 7QB, UK. Electronic address: w.lenney46@hotmail.co.uk.
authors: Warren
authors: W
authors: Lenney
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000628:therapy; D005951:Glucose Tolerance Test; D006801:Humans; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Cystic fibrosis; Cystic fibrosis-related diabetes