What is Cystic Fibrosis Related Diabetes (CFRD)?
Cystic Fibrosis Related Diabetes occurs when your body does not use insulin the way it should. Normally, food is broken into sugar, fat and protein. As sugar enters our blood, it signals the pancreas to release insulin to help cells get energy from the foods we eat. But people with diabetes do not have enough insulin to make this happen. Screening for CFRD
Your blood glucose, or sugar, levels should be tested once a year, says the Cystic Fibrosis Foundation. When you are in the hospital, your glucose levels should be measured during fasting (when you are not eating), and after a meal. You may be asked to drink a very concentrated glucose drink so doctors can measure your blood glucose levels. Symptoms of CFRD Include:
• Being very tired
• Weight loss
• Increased thirst
• Increased urination
• More lung problems
• Contact your CF team if you experience any of these problems. Treatment for CFRD
Monitoring blood sugars
If you have CFRD, your blood sugar levels have to be watched closely. An instrument called a glucometer can measure your blood sugar with a simple prick to the finger or arm. Your blood sugar should be checked before and after you eat to make sure you have enough insulin. Your CF team will help you decide how often to check your blood sugar. Medications
Insulin
Your body produces hormones, which influence how cells work which in turn keeps our bodies healthy. Insulin, for example, is a hormone that lowers blood sugar levels. Your body needs a balance of insulin and food to work properly. If you have CFRD, which means your body is not producing enough insulin, you will need to take extra insulin through an injection or pump. Different types of insulin may be used to treat CFRD. Your CF team will help you decide which combination works best for you. Oral Hypoglycemic Agents (pills)
The pills used to treat adults without CF who have diabetes have not been well-studied in treating CFRD. So, for now, they are not recommended for CF patients. Other Tests
Hemoglobin A1c
This test tells you if your blood sugars have been high during the last three months, which helps your CF team decide whether the treatment plan is working. Urine Microalbumin
This test looks for small amount of protein in the urine, which helps determine how well your kidneys are functioning. Nutrition
A healthy diet and determining your correct amount of daily insulin are very important in managing CFRD. Avoid sodas as they're high in sugar and have little nutritional value. Your nutritionist can teach you how to count carbohydrates. Managing Cystic Fibrosis Related Diabetes, a book offered by the CF Foundation, covers CFRD nutrition, low blood sugars, sick days and exercise. Contact your local CF care center or e-mail info@cff.org to request a copy.
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