Cystic Fibrosis Related-Diabetes

Casey Shield
May 20, 2010


Abstract:
Cystic Fibrosis Related-Diabetes is a type of diabetes only found in those affected by Cystic Fibrosis. CFRD is a combination of both Type I and Type II diabetes and has some of the same symptoms. CF patients have lo immune systems and therefore their organs begin to have problems, and in this case it is their pancreas. The pancreas begins having a hard time both making and absorbing insulin and then the patient is diagnosed with CFRD.
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Introduction:
Cystic Fibrosis-Related Diabetes (CFRD) is a unique type of diabetes that only effects those who have already been diagnosed with Cystic Fibrosis. CFRD is not the same as, but has similarities to both other types of diabetes, Type I diabetes, and Type II diabetes. As the age of the patient increases, so does the likelihood of have CFRD. CFRD is found in 35 percent of adults aged 20 to 29 and 43 percent for those over 30 years old, and those without diabetes often have some sort of glucose intolerance. As each year passes, the likelihood they will develop diabetes increases. As many as 16 percent of all patients with cystic fibrosis also have diabetes, a number that is expected to rise as overall life expectancy for cystic fibrosis patients increases. Cystic fibrosis patients suffer recurrent episodes of infection and inflammation that slowly destroy the lungs. The pancreas is also affected, interfering with proper digestion. The disease stems from a faulty gene that blocks the normal passage of salt and water through the body's cells. It is this gene deficiency that is proposed to cause insulin-producing cells to malfunction.


Discussion:
There are two types of diabetes in the non-CF population and then CFRD:

Type I diabetes (known as “insulin-dependent diabetes”)

o This type of diabetes, which is usually diagnosed in childhood, occurs when the pancreas does not produce enough insulin, a condition known as insulin deficiency. Due to these characteristics, type 1 diabetes used to be called "insulin-dependent" or "juvenile onset diabetes." People who have type 1 diabetes must take insulin shots every day of their lives or they could develop a life-threatening condition called "ketoacidosis".

Type II diabetes (known as “non-insulin dependent diabetes”)

This type of diabetes, which is usually diagnosed in adulthood, occurs when the pancreas produces enough insulin, but the body does not respond to the insulin properly, a condition known as insulin resistance. Due to these characteristics, Type 2 diabetes used to be called "noninsulin dependent" or "adult onset diabetes." People with Type 2 diabetes usually do not need to take insulin shots. Instead, they take pills that help their bodies use the insulin that they already have.

CFRD:
o Diabetes in people with cystic fibrosis combines the characteristics of both type I and type II diabetes. Build up of thick s
ecretions in the pancreas eventually damages the hormone-producing cells, causing insulin deficiency by damage to a pancreas that used to produce insulin normally. In addition to insulin deficiency, people with cystic fibrosis often wind up with insulin resistance because of chronic infections, high levels of cortisol, and frequent exposure to corticosteroids which are used as anti-inflammatory drugs to treat lung conditions. CFRD has some features of both types of diabetes. People with CF do not make enough insulin like those with Type I, due to scarring in the pancreas. They are also insulin resistant, like those with Type II, which means your body does not use insulin normally.

external image cysticfibrosis01.jpgSymptoms:
Common symptoms much like the other types of diabetes include:
o Increased thirst (polydipsia)
o Increased urination (polyuria)
o High blood sugar levels (hyperglycemia)
o Other symptoms of CFRD are excessive fatigue, weight loss and unexplained decline in lung function.

Diagnosis:

Since symptoms of CRFD may not be noticed in the early stages of the disease, CF patients must be tested often by blood tests that detect the levels of glucose in the blood.

Treatment/Conclusion:
CFRD is usually treated with a combination of insulin, exercise and diet. Insulin is the medication used to treat CFRD. It allows sugars and proteins to move from the blood into the body’s cells. It is used for energy and to build muscle. Keeping blood glucose levels at a normal or near-normal level helps you gain weight, feel better and have more energy. It also lowers the risk of problems caused by diabetes. The diet for people with CFRD is different than the calorie-restricted diet typically prescribed for people with other types of diabetes.




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Literature Cited:

Alma, From Lori. "Cystic Fibrosis Related Diabetes - Information About Cystic Fibrosis Related Diabetes." Cystic Fibrosis - Information About Cystic Fibrosis. Web. 20 May 2010. <http://cysticfibrosis.about.com/od/relateddiseases/a/CFRD.htm>.

"Cystic Fibrosis-related Diabetes Studied By UF." Medical News Today: Health News. Web. 20 May 2010. <http://www.medicalnewstoday.com/articles/46755.php>.

"Cystic Fibrosis Foundation - Cystic Fibrosis-Related Diabetes." Cystic Fibrosis Foundation - Home. Web. 20 May 2010. <http://www.cff.org/LivingWithCF/StayingHealthy/Diet/Diabetes/>.