title: The development of diabetes among Danish cystic fibrosis patients over the last two decades.
abstract: OBJECTIVE
  Cystic fibrosis (CF)-related diabetes (CFRD) is correlated with age and has been associated with a decline in body mass index (BMI), pulmonary function, and survival. Over the last two decades, the focus has been on the early diagnosis and treatment of diabetes; therefore, in this study, we evaluated the status of the current clinical condition and survival in our CF population. In addition, we also aimed to investigate the incidence of diabetes among adolescence over time and to identify characteristics associated with early diabetes onset.
  
  
  METHODS
  A retrospective chart review of a birth cohort consisting of 161 CF patients born between 1975 and 1994 and followed until 2011.
  
  
  RESULTS
  Over two decades, the incidence of CFRD among 11- to 16-year-old children remained unchanged at 12-14%, while the proportion of children with chronic pulmonary infection at age 10 declined from 31 to 8% (p < 0.001). Severe CF-mutation, i.e., group I and II mutations, were associated with diabetes (p = 0.003). Female gender was borderline associated with diabetes among adolescents (p = 0.06). No significant worsening in pulmonary function, BMI or survival was identified when comparing CFRD patients to CF patients without CFRD.
  
  
  CONCLUSIONS
  The incidence of diabetes among adolescence with CF has not changed over the last two decades. Severe CF mutations are a risk factor for CFRD, and female gender is borderline associated with CFRD among adolescents. Pulmonary function, BMI and survival were comparable regardless of the onset of CFRD.
authors.affiliation: Cystic Fibrosis Centre, Rigshospitalet, Copenhagen, 2100, Denmark.
authors.forename: Karin B
authors.initials: KB
authors.lastname: Knudsen
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
authors.forename: Vibeke
authors.initials: V
authors.lastname: Eriksen
authors.forename: Marianne
authors.initials: M
authors.lastname: Skov
authors.forename: Kim G
authors.initials: KG
authors.lastname: Nielsen
authors.forename: Jesper
authors.initials: J
authors.lastname: Johannesen
authors.forename: Tacjana
authors.initials: T
authors.lastname: Pressler
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications* / Q000401:mortality; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: clinical outcomes; cystic fibrosis; diabetes mellitus; epidemiology