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(08) 6110 0570admin@pdchealthhub.com.auCFRD is diabetes that develops because cystic fibrosis damages the pancreas, so it makes less insulin. It is found by a yearly glucose tolerance test from age 10, and insulin is the main treatment.
Cystic fibrosis related diabetes, usually shortened to CFRD, is diabetes that develops in people living with cystic fibrosis. Thick, sticky mucus damages the pancreas over time, so it makes less insulin, and glucose stays in the blood instead of getting into cells for energy.1,2 Insulin resistance can add to it, particularly during a chest exacerbation, on steroids or in pregnancy.2 It becomes more common with age, affecting about 15 per cent of children and 40 to 50 per cent of adults living with cystic fibrosis, and is one of the most common complications of cystic fibrosis in adults.1,2
CFRD is its own condition and is managed differently from type 1 and type 2 diabetes.1 It often causes no symptoms, so it is usually found by screening rather than because someone feels unwell.1,2 When symptoms do appear they are easy to put down to cystic fibrosis itself: weight loss, low energy, more hunger, or lung function slipping without an obvious reason.1 Nutrition is the other clear difference. Eating is planned with your cystic fibrosis and diabetes teams rather than by cutting food back, and carbohydrate is counted so that insulin can be matched to it.1,2
Screening is an oral glucose tolerance test, recommended every year from age 10 and done while someone is clinically stable. Younger children are screened if they have symptoms, unexplained weight loss, growth failure or a worsening respiratory picture.3 An oral glucose tolerance test is also recommended when planning a pregnancy if there has not been one in the past six months.1 Insulin is the main treatment, and other diabetes medicines are rarely used.1,2 Care stays shared: the cystic fibrosis team continues cystic fibrosis treatment, and the diabetes team works alongside it.1,3
PHOTO NEEDED · Add a Hero Image to this condition in the CMS: a PDC clinician with a client, natural light, no identifiable health information on screen
Symptoms are a guide, not a diagnosis. Your GP confirms the diagnosis; our team helps you manage it day to day.
The teams and services that most often support people with this condition. They work from one shared plan, and one GP referral reaches all of them.
This page follows Cystic Fibrosis Australia's Standards of Care for Cystic Fibrosis 2023 and the current Cystic Fibrosis Western Australia CFRD factsheet, with additional detail from the Cystic Fibrosis Foundation in the United States, because Australian consumer information on CFRD is brief. Emergency advice for a severe low glucose level and for diabetic ketoacidosis follows the NDSS and Healthdirect.
Because CFRD usually starts without symptoms, and the glucose tolerance test is the most sensitive way to pick it up. Australian cystic fibrosis guidance recommends it once a year from age 10, done while you are clinically stable rather than during an exacerbation. Finding it early means insulin can start before weight and lung function are affected.
Insulin is the main treatment for CFRD. Non insulin diabetes medicines are rarely used, although the Cystic Fibrosis Foundation notes some people may benefit from them. Your cystic fibrosis specialist or GP decides what you are prescribed. A diabetes educator then helps you get comfortable with the injections or pump, the timing and the dose adjustments.
No, and that is one of the biggest differences between CFRD and other types of diabetes. Your eating plan is built with your cystic fibrosis and diabetes teams rather than by cutting energy or fat back. Carbohydrate is counted so that insulin can be matched to the food, rather than the food being cut to suit the insulin.
Because the first effects often show up as things you would blame on cystic fibrosis. Cystic Fibrosis WA links controlled glucose levels to better nutrition, weight and lung function. Treating CFRD is part of protecting those, not a separate project.
Both, working together. Australian standards of care recommend referral to endocrinology, ideally a clinician experienced in CFRD, once CFRD is diagnosed, with HbA1c checked every three months. The cystic fibrosis team keeps running your cystic fibrosis care and the diabetes team does not change it. PDC can be the diabetes education, dietetics and exercise part of that arrangement, in person or by telehealth.
Tell us what is going on and we will point you to the right discipline, or to more than one. Most people start with a single appointment and leave with a plan the rest of the team can see.
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