Nutritional management of cystic fibrosis and cystic fibrosis-related diabetes in Australia

Abstract

Aim: The cystic fibrosis (CF) dietitians’ role is to determine individualised nutritional management plans for patients. The aims of the present study were: to (i) document nutritional management delivered by Australian dietitians to patients with CF and CF-related diabetes (CFRD); (ii) examine if advice is consistent between CF centres within Australia; and (iii) determine if dietetic staffing is adequate for patient numbers. Methods: A 25 question web-based survey was distributed via professional networks to dietitians working with adult patients with CF within Australia. Results: Subtle differences in practice were reported. Energy requirements were most commonly determined by the Schofield equation. Various methods were used to calculate protein and fat requirements. Education provided to patients with CFRD was relatively consistent between centres, but notably different from that reported in previous surveys. There were variations in waiting times to see patients newly diagnosed with CFRD, and review time frames for these patients varied significantly. The majority (82%) of CF centres were under staffed when compared with staffing levels outlined in standards of care. Conclusions: The results of the present study provide insight into the nutritional management delivered by Australian dietitians to patients with CF and CFRD, which is evolving over time. Standardising practice for the delivery of education and addressing inconsistencies between treating centres would assist in optimising care for CF patients. Dietetic staffing is inadequate at the majority of CF centres, which may limit the ability to provide effective management, especially in the context of increasing rates of comorbidites such as CFRD.