Cystic Fibrosis Specialist Dietitian, Belfast City Hospital
As one of our Clinical Champions, Veronica plans to investigate ‘did not attend’ (DNA) rates and the number of people offered oral glucose tolerance tests (OGTT).
From this she plans on implementing ways to overcome this so that all patients are offered screening.
Veronica also plans to carry out risk stratification to allow targeting of screening to high risk patients if risk factors were identified. This information would help guide the development of a local pathway/algorithm for diagnosis of CFRD and aid screening and earlier diagnosis.
This work will help to co-ordinate a pilot study into the use of continuous glucose monitoring (CGM) as an extra aid to diagnosis and treatment decisions and as an alternative to OGTT.
Background
Veronica has worked in the NHS for 11 years specialising in gastroenterology, diabetes and cystic fibrosis (CF). Veronica is particularly interested in CF-related diabetes (CFRD) and its impact on life expectancy.
Cystic Fibrosis is a genetic condition which causes a build-up of thick sticky mucus in the lungs and digestive system. The most common co-morbidity is Cystic Fibrosis-related diabetes (CFRD). CFRD results in decline in weight and lung function which precedes diagnosis and a six fold increase in mortality, with a 17 year difference in females. Studies have shown this affect in mortality can be narrowed and the sex difference eliminated with early treatment with insulin.
An audit in Northern Ireland in 2017 in the adult cystic fibrosis population showed low screening and prevalence rates compared to the rest of the UK. The overall aim of the project would be to increase screening of CF patients for CFRD to allow earlier diagnosis and treatment. This should improve pulmonary function, weight and survival.
