M.Med. (Internal Medicine), Faculty of Health Sciences, University of the Witwatersrand, 2011. / Background
Cystic fibrosis (CF) is one of the most common fatal autosomal recessive inherited
conditions in the Caucasian population. Survival of patients with cystic fibrosis has
increased due to optimal medical therapy and as a consequence, later complications such
as cystic fibrosis related diabetes (CFRD) may develop.
Materials and methods
A retrospective patient file review was conducted on all the patient files in the Adult
Cystic Fibrosis Unit, Ward 496, Charlotte Maxeke Johannesburg Academic Hospital.
The aim of the review was to determine the prevalence of Cystic fibrosis related diabetes
(CFRD) and to determine the characteristics of patients with CFRD in terms of age,
gender, genotype, lung function, body mass index (BMI), HBA1c, use of corticosteroids
and pancreatic function.
Patients were classified as normal glucose tolerance, impaired glucose tolerance or CFRD
based on the results of oral glucose tolerance testing. For statistical analysis, patients
with impaired glucose tolerance and CFRD were analyzed together under the group
abnormal glucose homeostasis.
50 patient files were reviewed.
Results
12 patients (24%) had normal glucose tolerance, 10 (20%) had impaired glucose
tolerance, 23 (46%) had CFRD without fasting hyperglycaemia and 3 patients (6%) had
CFRD with fasting hyperglycaemia. 2 patients (4%) did not have OGTT done and
therefore could not be categorised. The prevalence of CFRD was 54 % (including all
patients with CFRD without fasting hyperglycaemia and patients with CFRD with fasting
hyperglycaemia). 75 % of patients had abnormal glucose homeostasis. Statistical
analysis failed to demonstrate any significant difference in the characteristics of patients
with and without CFRD. This may be related to the small sample size. HBA1c values
were higher in patients with abnormal glucose homeostasis compared to patients with
normal glucose tolerance.
Conclusions
The prevalence of CFRD in the adult cystic fibrosis population at Charlotte Maxeke
Johannesburg Academic Hospital correlates with the prevalence of CFRD in other cystic
fibrosis centres. There were no statistically significant differences in the characteristics
of patients with and without CFRD.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/11178 |
| Date | 27 January 2012 |
| Creators | Romain, Marc |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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