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Journal of Cystic Fibrosis ; 20:S118, 2021.
Article in English | EMBASE | ID: covidwho-1735135


Objectives: In 2018 a new Adult Cystic Fibrosis Diabetes (CFD) servicewas established within the Blackpool Victoria Hospital Adult Cystic Fibrosis Service (BACFS). Over 3 years the number of patients in the BACFS has increased, reflecting an increase in patients with CFD requiring more diabetes specialist time (see table). Demands on the service were further impacted during the COVID-19 restrictions;however, this also inadvertently enhanced engagement between patients and the CFD service. Methods: 1. Designated CFD Clinics 2. Annual review 3. Policies and resources 4. Ongoing education of patients and clinicians (Table Presented) Results: 1. Designated clinics 2 Weekly CFD multidisciplinary team (MDT) review including Libre View discussions, new & transition patient clinics, follow-up clinic alternating with 2 weekly nurse-led clinics All patients with CFD have a Libre sensor fitted and share data 2. Annual review Due to COVID-19 restrictions, Libre view used for screening of CFD 2 weekly CFD MDT meeting to discuss Libre View data Discussion at CFD MDT re: diagnosis & treatment 3. Policies and resources Local and National protocols followed to screen for CFD and initiate early treatment Established resources for new patients starting insulin 4. Ongoing education of patients and clinicians Upskilled CF team regarding CFD annual review Contribute to journal club, local meetings and education for other specialities Joint working agreement with antenatal service at BVH Conclusion: There have been challenges to establish a CFD service around staffing hours, accommodation and cross cover. COVID-19 had further impacted this but the introduction of virtual working has increased patient contact without the need for face-to-face consultations. Further development is centred on working with local paediatric centres for the transition of patients and introduction of virtual, structured group education.

British Journal of Surgery ; 108:141-141, 2021.
Article in English | Web of Science | ID: covidwho-1539226
Journal of Cystic Fibrosis ; 20:S32-S33, 2021.
Article in English | EMBASE | ID: covidwho-1368820


Objectives: The gold standard of care for diagnosing Cystic Fibrosis-Related Diabetes (CFRD), as recommended by CF Trust and American Diabetes Association guidelines (Bridges et al., 2018), is to use the Oral Glucose Tolerance Test (OGTT). Flash Glucose Monitoring System (FGMS) was introduced for CF patients, shielding due to COVID-19, as part of their CF annual review (A/R) alongside chest status, weight and HbA1c. Methods: • A/R information sheet outlining reason for using FGMS and sharing data agreement via Libre View. • Video consultation with Dietitian/CF Diabetes Nurse to discuss and support insertion of Libre sensor and link to sharing data. • Patients completed 2 weeks of daily scanning and food diary. • 2 weekly CFRD MDT data analysis, using the Brompton CGM criteria for CFRD diagnosis (see table 1). [Table presented] Results: • Good uptake of CFRD screening process. • 13 patients screened with FGMS (see table 2). • Monitoring of glucose against timely food diary, using Libre View App. • FGMS has identified patients with impaired glucose handling that may have been missed on OGTT. • Patients able to observe effect of food on blood glucose levels. [Table presented] Conclusion: Using the FGMS has enhanced patient's compliance with A/R screening for CFRD. The FGMS has identified early diagnosis of patients with CFRD and patients with delayed insulin response leading to effective insulin treatment and appropriate dietary changes. Feedback to the patient following A/R has been quicker and more efficient due to video consultations and the sharing of glucose results and food diary via the App and Libre View sharing agreement. The role of FGMS at annual review allows closer analysis of glucose trends which otherwise would have been missed on the OGTT screening.