A patient whose pancreas does not work correctly often will develop diabetes because of pancreatic duct blockages and digestive enzyme damage. This impairs enzyme functions like regulation of insulin secretion. The reduced production of insulin results in diabetes.Diabetes occurs in 15 percent of CF patients over the age of 35. The CF-related diabetes (CFRD) has Type I and Type II characteristics, but CFRD is more similar to Type I diabetes because the pancreatic tissue that makes insulin is damaged by recurring blockages of the ducts and the development of fibrosis. | Type 1 | Type 2 | CFRD | | No insulin secretion | Slight insulin secretion | Slight insulin secretion | | Pancreatic cells are damaged | Pancreatic cells are damaged | Pancreatic cells are damaged | | Rapid onset or present at birth | Slow onset later in life | Presents between ages 16-20 | | Excessive thirst | Excessive thirst | Excessive thirst | | Increased urination | Increased urination | Increased urination | | Weight loss | Weight loss | Weight loss | | Abdominal pain | Abdominal pain | Abdominal pain | | Nausea | Nausea | Nausea |
Once diagnosed, strict blood sugar control is required by frequent monitoring and insulin injections. A decline of pulmonary function may be related to uncontrolled diabetes. Other compliations, including kidney, neurologic and eye disease, can occur. Eye Disease
CFRD damages the retina, resulting in diabetic retinopathy. CFRD will continue to damage the small blood vessels that supply the retinas, resulting in diminished vision in up to 15 percent of people with CFRD. Untreated, this can cause scarring, bleeding and detachment of the retina. Strict blood sugar control is essential, and yearly evaluations by an ophthalmologist are recommended. Neurologic Disease
CFRD can damage the nervous systems that control sensation. Similar to the damage caused in the retinas, blood supply to nerves that control sensation in the hands and feet is damaged, resulting in numbness in about 20 percent of people with CFDR. Strict blood sugar control is the best prevention. Kidney Disease
CFRD can also cause kidney damage known as diabetic nephropathy. Developing later in the course of the disease, symptoms include headaches, confusion, swelling of the legs, and decreased urination. If left untreated, the condition can cause kidney failure. Strict blood sugar control and monitoring of kidney function by blood and urine tests can help prevent this disease. Medications and lifestyle changes can slow it down.
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