A new study has revealed that a diabetes treatment can benefit many patients with an increasingly common complication of cystic fibrosis. Cystic fibrosis (CF), a genetic disorder that leads to chronic lung infections, once led inevitably to childhood death from scarring of the lungs. New treatments are helping people with CF live much longer—often into their 30s and 40s. However, as they age, an increasing number of people with CF are developing CF-related diabetes (CFRD), which has been associated with reduced survival. CF severely damages the pancreas, affecting first its vital role in producing digestive enzymes needed for food absorption from the intestine, and later its production of insulin needed to transport glucose fuel into cells. Replacement of lost digestive enzymes improves growth and nutrition, but sufficient insulin is also needed to maintain body weight and muscle mass. Still, because patients with CFRD may not be at risk for many of the serious complications associated with other forms of diabetes, the benefit of adding insulin therapy to the already burdensome CF treatment regimen has been uncertain. A recent clinical trial has now shown that aggressive insulin therapy, begun earlier in the course of their diabetes than previously recommended, can help many people with CFRD maintain their body weight and potentially avoid the excess mortality associated with CFRD.
Moran A, Pekow P, Grover P, Zorn M, Slovis B, Pilewski J, Tullis E, Liou TG, Allen H, and the Cystic Fibrosis Related Diabetes Therapy Study Group: Insulin therapy to improve BMI in cystic fibrosis-related diabetes without fasting hyperglycemia: results of the cystic fibrosis related diabetes therapy trial. Diabetes Care 32: 1783-1788, 2009.
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