Cystic Fibrosis Related Diabetes (CFRD)

The loss of insulin producing capacity is usually very gradual in cystic fibrosis and this type of diabetes is called Cystic Fibrosis Related Diabetes (CFRD). There is a long period during which insulin continues to be produced but levels are not quite enough to prevent hyperglycaemia after meals. Children are often screened for diabetes with an oral glucose tolerance test yearly once they are 12. Continuous glucose monitoring (for 6 days) is being used more frequently and provides a more detailed report recording blood sugars every 5 minutes, a food diary has to be recorded and 4 blood sugars during the period the monitor is on. About 50% of people with cystic fibrosis will be diabetic by the age of 30. Some children will require an insulin injection just to cover meals; others will require a more standard regimen because they produce no insulin. Blood sugar management may be complicated by artificial feeding, for example overnight gastrostomy feeding.

The principles of managing blood sugar are the same in children with cystic fibrosis as they are for children with type 1 diabetes. An injection regimen or an insulin pump may be used.

Children with cystic fibrosis will not follow a typical diabetic diet they will still be encouraged to eat as much as they can of a high fat high calorie diet. The only change might be to avoid high sugar snacks and drinks between meals and to have them with meals instead.