P-128: Glycemic profile of pediatric patients with cystic fibrosis at a tertiary center in Brazil
L Manolio Franco, D de Souza Paiva Borgli, J D Ribeiro, A F Ribeiro, A C Gonçalves, M Â Gonçalves de Oliveira Ribeiro, M Zorron Mei Hsia PuAbstract
Introduction
Cystic fibrosis-related diabetes (CFRD) is a major metabolic complication associated with worse pulmonary and nutritional outcomes. Early glycemic abnormalities often precede CFRD, and the oral glucose tolerance test (OGTT) is recommended as the gold standard for screening. However, its implementation remains inconsistent, and HbA1c has limited sensitivity.
Objectives
To evaluate the prevalence and profile of glycemic abnormalities in pediatric patients with cystic fibrosis (CF) at a tertiary center in Brazil and to compare findings with national and international data.
Methods
A retrospective observational single-center study including patients aged 8–18 years with confirmed CF followed between 2024 and 2025. Glycemic status was assessed using OGTT and HbA1c. Data were analyzed descriptively, and concordance between methods was evaluated.
Results
A total of 104 patients were analyzed. OGTT was performed in 78.8% (n=82), identifying glycemic abnormalities in 42.7%, including abnormal glucose tolerance - AGT (13.4%), impaired glucose tolerance - IGT (23.2%) and CFRD (4.9%). Overall CFRD prevalence was 4.8%, while 21.2% of patients did not undergo OGTT. Discordance between HbA1c and OGTT was observed: among patients with normal HbA1c, 12 had abnormal OGTT results, predominantly IGT. Substantial heterogeneity was observed among patients classified as pre-CFRD by HbA1c, reinforcing its limited sensitivity for early detection.
Conclusions
Glycemic abnormalities are highly prevalent in pediatric CF, particularly in early stages detectable by OGTT. HbA1c showed limited performance in identifying these alterations. Incomplete screening and variability in specialist follow-up highlight critical gaps in care, supporting systematic OGTT implementation and integrated multidisciplinary management. These findings were consistent with gaps reported in international registries.