Screening for disorders of glucose regulation in cystic fibrosis

People with cystic fibrosis suffer damage to the pancreas that, over time, reduces their ability to produce insulin. In some patients, this progresses to diabetes. The onset of diabetes can be insidious, and it can cause damage before symptoms of diabetes occur and lead to diagnosis. There are a number of different screening tests, some less popular than others. The planned research consisted of a systematic review of the evidence, an economic evaluation using de novo economic modelling, and surveys of current practice and patients’ views. However, no new economic evaluation was conducted owing to a lack of available data.

Outcome and Translation

The study provided an up-to-date summary of the evidence to inform the policy position of the UK National Screening Committee and other relevant decision makers. The study concluded that the definition of cystic fibrosis-related diabetes should probably be based on pulmonopathy risk, rather than using the classical definition of diabetes. This implies that we should be screening for a wider range of hyperglycaemia than in other forms of diabetes.

HERU researchers involved in this research project: Rodolfo Hernández

External Collaborators: N Waugh, P Royle (Population Health, University of Aberdeen); P Helms (Applied Clinical Sciences, University of Aberdeen); K Stein, MA Pitt (Peninsula Medical School); P Ewings (Royal Devon and Exeter NHS Trust); IP Craigie (Royal Hospital for Sick Children) and C Sheldon (Royal Devon and Exeter NHS Trust)

This research contributed to the HTA:

Waugh, N., Royle, P., Craigie, I., Ho, V., Pandit, L., Ewings, P., Adler, A., Helms, P., Sheldon, C. (2012) 'Screening for cystic fibrosis-related diabetes: a systematic review', Health Technology Assessment, 16 (24)