Advancing Cystic Fibrosis-Related Diabetes Care With Automated Insulin Delivery Systems

Purpose: Cystic fibrosis-related diabetes (CFRD) is the most common comorbidity in cystic fibrosis (CF), associated with faster lung decline and higher mortality. Insulin is the recommended therapy, but its management is challenged by fluctuating insulin needs and the overall CF treatment burden. Automated insulin delivery (AID) systems may help improve glycemic control and quality of life (QoL), though evidence in CFRD is limited. To assess the impact of switching from multiple daily injections (MDI) or sensor-augmented pump (SAP) therapy to AID on treatment satisfaction and diabetes-related QoL in adults with CFRD. Methods: In this prospective cohort study, 21 adults with CFRD were offered AID in place of MDI or SAP. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Audit of Diabetes-Dependent Quality of Life (ADDQoL) were administered at baseline and after 3 months. Primary outcomes were changes in DTSQ and ADDQoL scores; secondary outcomes included continuous glucose monitoring (CGM) metrics. Results are reported as median with interquartile range (IQR). Findings: After 3 months of AID use, DTSQ scores improved from 22 (IQR: 19–23) to 33 (IQR: 31–35), P < 0.001. ADDQoL scores increased from −2.1 (IQR: −2.7 to −1.2) to −0.9 (IQR: −1.7 to 0.5), P < 0.001. CGM metrics also improved significantly. Implications: These findings provide preliminary evidence suggesting that AID may be a useful tool in the management of CFRD.