A unique type of diabetes, CFRD is a common complication for people with cystic fibrosis, especially as they age. CFRD is found in 40-60% of adults with CF.
Most people who develop diabetes are glucose intolerant for several years before diabetes becomes obvious. Diabetes develops because these people are slow to clear extra sugar from their blood.
Common symptoms include
CFRD is typically diagnosed in young people between 18 and 24 who are pancreatic insufficient and carry a more ‘severe’ CF gene mutation.
There are two types of tests for CFRD: an oral glucose tolerance test (OGTT), which measures blood sugar levels two hours after drinking a ‘sugar’ solution; and a fasting blood glucose test (FBG), where individuals fast the evening before taking the test. A blood sugar level above 11.1 mmol/l indicates diabetes. These tests should be performed annually and given to those not yet tested for diabetes, as part of routine management of CF.
Early diagnosis and proper management is key to CF and diabetes care. Some people with CFRD may require up to 4,000 calories a day. Nutritionists recommend a high-energy diet including 35-40% fat, 20% protein and 40-45% carbohydrates. Typically, insulin is also used to treat CFRD. Insulin allows sugars and proteins to move from the blood into the body’s cells to provide energy and build muscle.
Good diabetes management depends on a person’s willingness to take an active role in his/her care.
Keeping blood glucose levels at a normal or near-normal level helps people with CF gain weight, feel better, and have more energy. It also lowers the risk of problems caused by diabetes.
Developing CFRD can impact a person’s physical and psychological well-being. Diabetes creates a secondary illness for a person with CF. However, with adequate care and a positive outlook, CFRD can be managed effectively.
Cystic Fibrosis Canada is currently funding a special research Team Grant on CFRD.
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