Figure 1 Quality improvement strategies over 2018-2020 to improve OGTT screening. OGTT – oral glucose tolerance test (number of eligible patients = 95).

The limitations of this study is it is from a single centre, there are small numbers and lastly some of the results are limited by patients leaving Western Australia or transitioning to adult services. Lessons learnt included – Routine screening for CFRD using OGTTs in children and young people with CF can be challenging. Rates of screening can be improved with a series of PDSA cycles. Such enhanced screening resulted in newly diagnosed cased of CFRD. However further work is required to determine how to get to 100% annually. Abnormal glycaemic control is common in a contemporary population of children and young people with CF, despite improved health compared to historical cohorts, and increasing use of CFTR modulator therapy. Screening is still required, as there are patients with impaired glucose tolerance and CFRD with no change symptoms like weight loss, and reduced FEV₁. They may also already be on modulator therapy.

This quality improvement project showed an improvement in screening for CFRD in a CF cohort, which was the original aim. CF care is changing however ongoing screening for abnormal glycaemic control is required. Over the next decade as modulator therapy becomes more available and at a younger age – screening for current complications may need to be lessened.