? Core 1: Diabetes, GI, and Nutrition Core Major advances in the management of pulmonary disease in cystic fibrosis (CF) have led to a needed redirection of research to non-pulmonary comorbidities. Critical knowledge gaps exist in three key areas: 1) chronic endocrine complications, including CF-related diabetes (CFRD); 2) gastrointestinal (GI) and hepatic manifestations, including CF-related liver disease (CFLD); and 3) assessment and optimization of nutritional status. Individuals living with CF commonly experience comorbidities in one or more of these domains that significantly impair their overall quality of life and can reduce their long-term survival. In addition, little research has yet been conducted relevant to endocrine, GI, or nutritional issues in CF patients receiving CFTR modulators. The major goal of the Diabetes, GI, and Nutrition (DGN) Core of the Georgia CF Research and Translation Core Center (Georgia CF Core Center) is to support the research and training of clinical and translational scientists in non-pulmonary, NIDDK mission-related research in children and adults with CF. The DGN Core will consist of three integrated Sub-Cores, each providing unique and complementary faculty expertise and resources. These are: 1) Diabetes/Endocrine Sub-Core, 2) GI/Liver Sub-Core, and 3) Nutrition Sub-Core. The nature of the research supported by the DGN Sub-Cores is conducive to integrative interactions between each Sub-Core and with all other activities in our proposed Georgia CF Core Center. Each DGN Sub-Core will provide novel serial data obtained from annual research oral glucose tolerance test visits in children and adults with CF to the Georgia CF Data Warehouse, a state-wide data repository proposed by the Clinical Research and Informatics Core. We hypothesize that the DGN Core will lead to: 1) more impactful CF research; 2) more investigators new to CF performing multi-disciplinary research; 3) new collaborations linking DGN Core leadership and users to internal and external CF investigators; and 4) earlier detection, better diagnostics, and better treatment of CF comorbidities. We propose four specific aims to meet the goals of the DGN Core:
Specific Aim 1 : To provide a novel platform for established and new CF investigators wanting to incorporate diabetes, bone, sex/reproductive health, and other endocrine endpoints into their research (Diabetes/Endocrine Sub-Core).
Specific Aim 2 : To aid CF investigators interested in CF GI/liver disease with access to state-of-the-art tools and measurements, study design guidance, and data interpretation services (GI/Liver Sub-Core).
Specific Aim 3 : To provide scientists performing CF research with access to state-of-the-art tools and measurements, study design guidance, and data interpretation services related to nutrition and body composition outcomes (Nutrition Sub-Core).
Specific Aim 4 : To provide education, training and critical new outreach to promote interest and maximize DGN Core usage for clinical and translational research in CF across the lifespan.
