O-15: Heterogeneity of cystic fibrosis related diabetes in the pediatric population in Poland: data from a multicenter Cross-Sectional study
W Roesler-Wilhelm, B Głowińska-Olszewska, E Niechciał, A Olejniczak, K Robak-Kontna, J Nazim, M Seifert, M Tarasiewicz, A Wołoszyn-Durkiewicz, S Więcek, A ChobotAbstract
Introduction
Cystic fibrosis-related diabetes (CFRD) is one of the most common metabolic complications of cystic fibrosis (CF). In recent years, treatment options have improved significantly, both in CF (CFTR modulators) and in diabetes (continuous glucose monitoring (CGM) and insulin pumps). However, current data on the treatment and glycemic control of children with CFRD in Poland are lacking.
Objectives
To present results of a multicenter, cross-sectional analysis of treatment methods, monitoring and metabolic control in Polish children with CFRD.
Methods
All of the 17 pediatric diabetes centers in Poland were contacted; 14 responded (March 2025-March 2026), 6 reported following no pediatric CFRD patients, and 8 shared anonymized data regarding all 33 children (21 girls and 12 boys) they followed. Demographic, clinical, laboratory, anthropometric, and selected organ function data were analyzed, along with insulin therapy, and glycemic (HbA1c, CGM) parameters where available.
Results
Mean age was 14.63±3.65 years, and mean age at CFRD diagnosis was 12.41±3.04 years. Mean HbA1c was 5.96±0.93%. Nineteen patients used CGM, with a mean time in range (70-180 mg/dl) of 80.8±15.8%. 17 patients did not receive insulin due to borderline glycaemic results. Among 16 insulin-treated children, 11 used multiple daily injections and 5 used insulin pumps, including 3 automated insulin delivery closed-loop systems. CFTR modulators were used in 20 patients, while 13 remained on standard therapy. Nutritional status and selected biochemical parameters varied substantially.
Conclusions
The revealed variability in therapeutic approaches highlights the need for a nationwide follow-up and standardized care strategies for pediatric CFRD in Poland, although children with CFRD represent a small proportion of all diabetes cases. It seems that some patients with CFRD may remain exclusively under CF center care and are not referred to specialized pediatric diabetes centers.