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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01091025
Other study ID # CRO-1210
Secondary ID
Status Completed
Phase N/A
First received March 18, 2010
Last updated December 20, 2017
Start date March 2009
Est. completion date January 2010

Study information

Verified date March 2010
Source Imperial College London
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The incidence of cystic fibrosis related diabetes (CFRD) has risen significantly as patients' survival improves. Early diagnosis of CFRD is crucial to prevent the unnecessary deterioration of lung function and nutritional status, both of which affect the patient's overall survival. The oral glucose tolerance test (OGGT) is the accepted method for detecting CFRD. The Cystic Fibrosis Trust guidelines (2004) recommend that patients with CF over the age of twelve years should be screened annually. Most hospitals use an annual OGTT. Performing OGTT on all CF patients is inconvenient and may not be cost effective, as patients have to starve overnight and need to spend an extra 2 hours in the hospital in addition to all the other annual review tests. In our centre, a selective approach is used. If patients have an abnormal random blood glucose and /or abnormal glycosylated haemoglobin (HbA1c) and/or symptoms of hyperglycaemia or unexplained weight loss then an OGTT will be performed.

The aims of this study are

1. To compare the clinical efficiency in the screening for CFRD in the two different methods: i)a selective approach , ii)an unselected annual OGTT for all patients.

2. To compare the cost effectiveness of the two approaches in the screening for CFRD.


Description:

CFRD affects 30% of all patients with cystic fibrosis (CF) by the age of twenty−five. Early diagnosis of CFRD is crucial to prevent the unnecessary deterioration of pulmonary function and nutritional status, both of which affect the patient's overall survival. The selective approach takes less patient time and is less expensive. If it is equally accurate it should be used routinely. The oral glucose tolerance test (OGTT) is the accepted method for detecting CFRD and the Cystic Fibrosis Trust guidelines recommend that patients with CF over the age of twelve years should be screened annually. Yung et al, questioned this approach and argued that performing OGTT on all CF patients is inconvenient and may not be cost effective, as patients have to starve overnight and need to spend an extra 2 hours in the hospital in addition to all the other annual review tests.

In this study, a selective approach in performing OGTTs in the screening for CFRD will be used; this includes the use of a combination of clinical and biochemical criteria that of abnormal random blood glucose and /or abnormal glycosylated haemoglobin (HbA1c) and/or symptoms of hyperglycaemia, or weight loss.


Recruitment information / eligibility

Status Completed
Enrollment 100
Est. completion date January 2010
Est. primary completion date December 2009
Accepts healthy volunteers No
Gender All
Age group 16 Years and older
Eligibility Inclusion Criteria:

- first one hundred consecutive clinically stable patients with CF attending annual review from January 2009

- 16 years of age and over will be eligible for the study.

Exclusion Criteria:

- patients with an existing diagnosis of CFRD.

- patients with an infective exacerbation (i.e. on a new course of antibiotics)

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Glucose profile for 2 weeks
A study subject has an abnormal OGTT will be referred to a cystic fibrosis consultant who is not involved in the study.

Locations

Country Name City State
United Kingdom Royal Brompton & Harefield NHS Foundation Trust London

Sponsors (2)

Lead Sponsor Collaborator
Imperial College London Royal Brompton & Harefield NHS Foundation Trust

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary To identify if using the selective approach to screen for CFRD is as accurate as screening all patients with OGTT at annual review. Patients identified for OGTT based on the selective approach by the two independent reviewers will be compared.
Patients will form two groups:
i)those identified as needing OGTT, ii)those on whom they considered it unnecessary
The results of the two groups will then be compared with the data obtain from OGTT to which the two reviewers were 'blinded'
6 months
Secondary Which is the more cost effective way of screening all patients with OGTT? Calculate the cost of glucose powder and laboratory analysis for each OGTT.
Compare the cost effectiveness of carrying out OGTT on patients identified by the selective approach with the cost of carrying out OGTT on all patients.
6 months