Cystic fibrosis-related diabetes mellitus Not hyperglycemia, but catabolism is crucial

With increasing life expectancy, cystic fibrosis also results in an increasing incidence and prevalence of diabetes mellitus. Cystic fibrosis-related diabetes (CFRD) differs from other types of diabetes mellitus. In addition to CFRD, CF patients can also develop diabetes mellitus under steroid therapy, in the context of acute infections, or during pregnancy (gestational diabetes), then generally temporarily, but which may also require insulin. Women with CF develop diabetes mellitus more frequently than men with CF, and since it usually accompanies the affected person for life, comprehensive knowledge and good patient education are of great importance. CF patients with diabetes mellitus have a worse course of disease and a higher mortality rate; thus, it is important to diagnose the disease at an early stage in order to initiate adequate treatment from the beginning. Well-treated diabetes mellitus has a positive effect on the further disease course. Current deeper understanding about pathogenesis, course, and optimal therapy allows better control of CFRD with increased quality of life and life expectancy. CF patients with diabetes mellitus do not have to follow a strict diet. Conscious eating, balanced meals, and good knowledge of food in relation to the metabolism of carbohydrates, fats, and protein is important. Insulin therapy is the treatment of choice, although repaglinide may be an alternative in early stage CFRD for some patients.