Pediatric endocrinologist Malinda Wu discusses ongoing research at Johns Hopkins on cystic fibrosis-related diabetes during the 2023 North American Cystic Fibrosis Conference. Cystic fibrosis is most commonly known for causing lung disease, but it affects most organs in the body, including exocrine and endocrine functions of the pancreas. CF-related diabetes is associated with worse lung function, worse nutritional status and decreased survival. Prompt treatment with insulin can reverse these outcomes, which makes it important to detect cystic fibrosis-related diabetes early.
Hello. My name is Melinda Wu. I am a pediatric endocrinologist at Johns Hopkins at the 2023 North American Cystic fibrosis conference. I presented our ongoing research. Cystic fibrosis is a genetic disorder caused by defective CFTR channels. CF is most commonly known for causing lung disease but affects most organs in the body including exocrine and endocrine function of the pancreas. CF related diabetes is associated with worse lung function, worse nutritional status and decreased survival. Prompt treatment with insulin can reverse these outcomes which makes it important to detect CFRD. Early current guidelines are to screen for CFRD with an annual oral glucose tolerance test in all people with CF, regardless of their personal risk for CFRD. We use data from 1300 people previously enrolled in the CF twin and sibling study which was led by my collaborator, Doctor Scott Blackman to create models to estimate the individual's near future risk of developing CFRD in the next one, 12 or five years. In our model measures of abnormal glucose including the two hour oral glucose tolerance test result and an A one C greater than 6% were significant predictors of near future CFRD. Onset. We identified some individuals who had very low risk of developing CFRD in the next two years who could potentially have a decreased frequency of CFRD screening with OG TT. However, we also identified some individuals with a very high risk of developing CFRD in the next year who may benefit from an increased frequency of screening for CFRD or methods. In addition to the OG TT, we are currently supported by the Department of Pediatrics Innovation Award to respectively validate our models as well as to incorporate additional measures of abnormal glucose including a continuous glucose monitor which measures interstitial glucose every five minutes for more than a week and a one hour OGTT glucose collected. In addition to the two hour OGTT glucose, our goal is to eventually bring our research back to the patient and their health care team to enable personalized recommendations for CFRD screening for each individual with CF. Thank you.
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