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Cystic fibrosis-related diabetes screening at a large pediatric center

Anil K Chokkalla1,2, Pamela Tuley3, Miray Kurtca1,2

  • 1Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, US.

Laboratory Medicine
|February 22, 2024
PubMed

Insights

Improving diabetes screening in pediatric cystic fibrosis (CF) patients is crucial. A quality improvement plan significantly boosted oral glucose tolerance test (OGTT) completion rates, enhancing early detection of diabetes in CF populations.

Area of Science:

  • Pediatric Endocrinology
  • Cystic Fibrosis Research
  • Quality Improvement in Healthcare

Background:

  • Cystic Fibrosis Foundation guidelines mandate annual diabetes screening for pediatric patients aged 10+.
  • Current nationwide screening adherence for cystic fibrosis-related diabetes is suboptimal.
  • The COVID-19 pandemic negatively impacted screening rates.

Purpose of the Study:

  • To assess current diabetes screening rates in pediatric patients with cystic fibrosis (CF).
  • To implement and evaluate a quality improvement plan to enhance screening adherence.
  • To improve the detection of diabetes in this vulnerable population.

Main Methods:

  • A 4-year retrospective audit of oral glucose tolerance test (OGTT) completion was performed.
  • A multidisciplinary working group identified barriers and developed a quality improvement strategy.
  • The impact of the intervention on screening rates was monitored over 9 months.

Main Results:

  • Diabetes screening rates via OGTT completion declined from 2019 to 2022.
  • Following the quality improvement plan, OGTT ordering and completion rates significantly increased.
  • Fractional OGTT completion rose from 45% (pre-intervention) to 70% (post-intervention).

Conclusions:

  • Quality improvement initiatives can effectively enhance diabetes screening in pediatric CF patients.
  • Optimizing patient experience, care coordination, and lab strategies are key.
  • Improved screening facilitates earlier diagnosis and management of cystic fibrosis-related diabetes.
Abstract

Keywords:
cystic fibrosisdiabetesglucose tolerance testquality improvement

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