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Association between HbA1c and the development of cystic fibrosis-related diabetes

M Choudhury1,2, P Taylor3, P H Morgan4

  • 1All Wales Adult Cystic Fibrosis Centre, University Hospital Llandough, Cardiff, UK.

Diabetic Medicine : a Journal of the British Diabetic Association
|January 31, 2019
PubMed

Insights

Glycated hemoglobin (HbA1c) predicts future cystic fibrosis-related diabetes (CFRD) and retinopathy risk. An HbA1c level of 37 mmol/mol or higher indicates increased risk, aiding in early identification of individuals needing closer monitoring.

Area of Science:

  • Endocrinology
  • Pulmonology
  • Ophthalmology

Background:

  • Cystic fibrosis (CF) patients are at increased risk for diabetes.
  • Cystic Fibrosis-Related Diabetes (CFRD) diagnosis and management remain challenging.
  • Microvascular complications like retinopathy are significant concerns in CFRD.

Purpose of the Study:

  • To evaluate Hemoglobin A1c (HbA1c) as a predictive marker for CFRD development.
  • To assess the association between HbA1c levels and the incidence of retinopathy in CFRD patients.

Main Methods:

  • A 7-year retrospective longitudinal study of 50 adults with CF.
  • Comparison of oral glucose tolerance test (OGTT) results with HbA1c values.
  • Analysis of retinal screening data against HbA1c measurements.

Main Results:

  • An HbA1c ≥37 mmol/mol (5.5%) significantly predicted dysglycemia development (HR 3.49, CI 1.5-8.1).
  • Higher HbA1c levels correlated with increased severity of diabetic retinopathy.
  • Longer duration of CFRD was also associated with retinopathy severity.

Conclusions:

  • HbA1c levels are linked to future dysglycemia and microvascular outcomes in CF patients.
  • While not a primary diagnostic tool for CFRD, HbA1c can identify at-risk individuals.
  • HbA1c may assist in proactive management and monitoring of CFRD development and complications.
Abstract

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