All patients with an abnormal OGTT were referred to the Barbara Davis Diabetes Center. Routine diabetes care was then coordinated by that clinic.

The CF dietician met with all patients to help coordinate care with the Barbara Davis Center dietician.

At time of diagnosis of CFRD and for all patients with previously diagnosed CFRD, clinic staff offered urine microalbumin-to-creatinine ratio testing and recommended an annual dilated retinal examination.

Clinic staff offered insulin therapy to patients with diagnosed CFRD and recorded the decision to initiate the therapy.

Staff recorded the number of acute pulmonary exacerbations, pulmonary function tests and measurements of BMI for the year before and the year after a diagnosis of CFRD.

The dietician or other personnel would track that patients were getting tests and referrals. At preclinic team meetings, the staff notified physician providers which patients needed CFRD follow-up care.

The staff revised the patient assessment form for clinic visits to flag the need for CFRD-focused physical examinations and referrals and provided a check box to indicate that tests were actually performed in the prior year.

Laboratory testing was ordered prior to clinic visits, and patients were asked to obtain testing prior to clinic. At clinic, patients were reminded to obtain the tests if they had not been performed.

The team generally increased the discussion and education about CFRD with patients at every visit and explained the need for testing. Patients that failed to get tests were provided additional education.

Physicians were reminded by clinic staff to perform appropriate CFRD-related physical examinations.

Patients were referred annually for dilated eye examinations.

Physicians were reminded by clinic staff to include urinary microalbumin and serum fructosamine in annual laboratories.

Dietician counted the procedures performed for CFRD follow-up and informed the clinicians.

CFRD follow-up measures were included as part of the annual review by the clinical nurse coordinator for each patient.

Input from the dietician and other personnel on CFRD follow-up was reported to the clinicians.

Clinic staff reminded the physician to perform appropriate CFRD-related physical examinations.

Patients were referred by clinic staff for dilated eye examinations. If not performed by the next visit, patients were reminded.

The local electronic medical record physical examination form was modified to highlight the need for CFRD-specific examinations such as foot examinations to cue the clinicians to perform these follow-up examinations.

Standard clinic laboratory orders were modified to automatically include HbA1c and urine microalbuminuria testing.

Clinic staff kept track of appropriate CFRD-related physical examinations and tests.

Staff provided education to each other and to patients to encourage increased numbers of CFRD-specific physical examination elements and to order CFRD-specific laboratory tests and referrals for retinal eye examinations.