Endocrine Care During Transition in Emerging Adults With Cystic Fibrosis: A Single Center Retrospective Study
Crystal Cobb1, Jenna Feeley2, José Nilo G Binongo3
1Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Summary
Endocrine complications like cystic fibrosis-related diabetes (CFRD) and bone disease (CFBD) worsen in emerging adults transitioning to adult cystic fibrosis (CF) care. Increased screening during this vulnerable period is crucial.
Area of Science:
- Endocrinology
- Pulmonology
- Pediatrics
Background:
- Cystic fibrosis (CF) commonly presents with endocrine issues, including cystic fibrosis-related diabetes (CFRD) and cystic fibrosis-related bone disease (CFBD).
- The transition from pediatric to adult care is a critical period for managing CF endocrinopathies, yet trends during this phase are understudied.
Purpose of the Study:
- To investigate changes in glycemic control (CFRD) and bone density (CFBD) in emerging adults with CF up to 10 years post-transition to adult care.
- To analyze endocrine screening rates during this transition period.
Main Methods:
- Retrospective chart review of 94 participants (ages 18-30) transitioning to adult CF care.
- Comparison of bone mineral density (BMD) and vitamin D status.
- Analysis of hemoglobin A1c (HbA1c) trends over time using linear mixed-effects models.
Main Results:
- Participants with CFRD on insulin showed a significant increase in HbA1c (7.8% to 9.4%) within five years of adult care (p=0.003).
- 47% of emerging adults had at least one low BMD Z-score (<-1).
- Low completion rates were observed for oral glucose tolerance tests (OGTT) and DXA screenings.
Conclusions:
- Health outcomes for CFRD and CFBD deteriorate during the pediatric to adult care transition in CF patients.
- Healthcare providers must acknowledge this vulnerable transition phase and implement enhanced screening programs for CFRD and CFBD.
Keywords:
adolescentscystic fibrosiscystic fibrosis-related bone diseasecystic fibrosis-related diabeteshealth care transitionMore Related Videos
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