Cystic Fibrosis-Related Diabetes

Insulin is the key that helps glucose (sugar) get into your cells. With cystic fibrosis-related diabetes (CFRD), the body doesn’t make enough insulin and sometimes lacks normal responses to it.

The Importance of Knowing Your Condition

This insulin deficiency is partly due to the scars in the pancreas caused by the thick, sticky mucus of cystic fibrosis. The insulin resistance can come and go, with causes such as high amounts of stress, an underlying infection, chronic inflammation, and use of steroids. This is why some people with cystic fibrosis only need to take insulin while they're in the hospital or sick.

People with undiagnosed CFRD often have an inability to gain or maintain weight. This is because the glucose is in the blood and not in the cells where it can be used for energy. This can lead to long-term hyperglycemia (high blood sugar) which can cause lung infections and a decrease in lung function.

Please note: Cystic fibrosis patients are also prone to hypoglycemia (low blood sugar), but this is not typically related to the development of CFRD.

 

Prevention and Identification of Cystic Fibrosis-Related Diabetes

Because CFRD can cause significant health complications, it's important that we understand and monitor your risk for developing this condition. In accordance with the recommendations of the Cystic Fibrosis Foundation, our team will monitor your risk in two important ways: 

  1. Routine checks of your blood sugar levels in the hospital and in clinic
  2. Oral glucose tolerance testing (OGTT), when A1c level is 5.8 or above

Early diagnosis and treatment will improve your overall health, your nutritional status, your lung function, and your survival. 

Contact the St. Luke's Cystic Fibrosis Center of Idaho with questions.

Testing, Diagnosis and Treatment

Oral glucose tolerance testing measures your body's response to sugar. You do not need an appointment and may go to any St. Luke’s lab for the test, as long as the order has already been placed by the CF team.

What to Expect

  • The test is conducted in the morning. You’ll be asked to fast (no food or beverages, except water) for at least 8 hours beforehand. You should eat your usual diet for 3 days before the test. 
  • You'll be given a sweet beverage to drink containing a lot of sugar dissolved in water. Then you’ll sit or lie quietly for 2 hours. Your blood sugar will be measured before you drink the beverage and again one and two hours later.

Please bring a snack for immediately after the 2-hour blood sugar check, as you will likely not feel very well. It's best to have someone drive you home from this test.