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Gaps persist in education for patients with cystic fibrosis-related diabetes
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Pediatric Academic Societies’ Annual Meeting 2011
Increased knowledge about cystic fibrosis-related diabetes did not correlate with better adherence to recommendations for management among children with the disease, according to the results of a recent survey.
To gain insight into patients’ knowledge about cystic fibrosis-related diabetes, researchers at the Rainbow Babies and Children’s Hospital in Cleveland developed the Cystic Fibrosis Diabetes Knowledge Survey. Participants were asked about the pathophysiology, symptoms, management and complications associated with the disease.
The researchers included 32 patients with cystic fibrosis-related diabetes and 33 patients without the disease, all of whom were aged 14 years or older. Results indicated that patients with cystic fibrosis-related diabetes had considerably higher knowledge scores than those without (83% vs. 72.2%; P<.001). Higher scores in this group also correlated with lower age (P=.01) and lower BMI (P=.008), according to the researchers. However, no relationship was observed between knowledge scores and HbA1c levels, forced expiratory volume or duration of disease.
Despite receiving information on symptoms, management and complications, 25% of patients were not educated about how to diagnose cystic fibrosis-related diabetes or its effects on pulmonary status. Further, survey results indicated that at least 25% of patients were unaware of the potential relationship between poor management of the condition and lower pulmonary function tests and weight loss.
The researchers reported a negative correlation between adherence to diabetes care and the HbA1c levels of patients with cystic fibrosis-related diabetes (P=.0064) and a positive correlation between adherence and BMI (P=.02). However, data also suggested that adherence score correlated negatively with knowledge score (P=.01).
“Our surveys identified that adherence, but not diabetes knowledge, correlated with better glycemic control,” the researchers wrote. “We have identified gaps in diabetes knowledge, especially relating [cystic fibrosis-related diabetes] to weight and pulmonary status, which will guide improvements in [cystic fibrosis-related diabetes] education.”
For more information:
- Kaminski B. Poster 2938.407. Poster session: Endocrinology & diabetes. Presented at: Pediatric Academic Societies 2011; April 30-May 3, 2011; Denver.
It is not surprising that adherence to the diabetes regimen correlates with better glycemic control and nutritional status in patients with cystic fibrosis-related diabetes. The researchers have determined that approximately 28% of cystic fibrosis adolescents and adults without diabetes and 17% of those with diabetes at their institution do not understand the role that cystic fibrosis-related diabetes plays in cystic fibrosis clinical decline. Given the critical relation that emerges during adolescence between cystic fibrosis-related diabetes and increased morbidity and mortality from pulmonary disease, they have identified a target area for their educational efforts.
– Antoinette Moran, MD
Professor and
Division Chief, Pediatric Endocrinology
University of Minnesota
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