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What is Cystic Fibrosis Related Diabetes (CFRD)?
Cystic Fibrosis Related Diabetes (CFRD) occurs when the body does not use the hormone insulin properly. Normally, food is converted into sugar, fat and protein. As sugar enters your blood it signals the pancreas to secrete insulin, allowing cells to derive energy from food. People with diabetes either do not make enough insulin (Type 1) or do not respond appropriately to insulin (Type 2), which means that food is not converted into energy. CFRD, which can be intermittent or chronic, has characteristics of both types. Diabetes treatments aim to keep blood sugar levels as close to normal as possible. Screening for CFRD
The Cystic Fibrosis Foundation recommends that fasting blood glucose levels be tested yearly. During hospitalizations, glucose levels should be measured during fasting and after eating. An oral glucose tolerance test (OGTT), performed annually in patients over age 13, measures blood glucose before and two hours after drinking a very concentrated glucose drink. The OGTT, which can diagnose diabetes and milder forms of blood sugar abnormalities, divides patients into four categories: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), diabetes without fasting hyperglycemia (the blood sugar is normal first thing in the morning but gets high after eating), and diabetes with fasting hyperglycemia (the blood sugar is always high, even without eating).
Symptoms of CFRD | CFRD Symptoms | | Fatigue | | Weight loss | | Increased thirst | | Increased urination | | Unexplained worsening of pulmonary function |
Contact your CF team if you experience any of these symptoms. Diagnosis of CFRD
Diagnosis of CFRD can be done with a variety of tests: fasting blood sugar, casual (anytime) blood sugar, or an oral glucose tolerance test (OGTT). The criteria used to diagnose CFRD are the same as for all forms of diabetes:
Diagnosing CFRD | Fasting
(morning before eating) | > 126 mg/dl on 2 or more occasions | | Random glucose level | > 200 mg/dl on 2 or more occasions | | Two hour plasma glucose | > 140 mg/dl 2 hours after drinking sugar solution |
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