Diabetes: A major co-morbidity of cystic fibrosis

被引:74
|
作者
Costa, M
Potvin, S
Berthiaume, Y
Gauthier, L
Jeanneret, A
Lavoie, A
Levesque, R
Chiasson, JL
Rabasa-Lhoret, R
机构
[1] CHUM, Res Ctr, Res Grp Diabet & Metab Regulat, Montreal, PQ, Canada
[2] CHUM, Cyst Fibrosis, Montreal, PQ, Canada
[3] CHUM, Res Grp, Montreal, PQ, Canada
[4] Univ Montreal, Dept Nutr, Metab Res Unit, Montreal, PQ H3C 3J7, Canada
关键词
cystic fibrosis; diabetes; insulin therapy;
D O I
10.1016/S1262-3636(07)70189-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cystic fibrosis-related diabetes (CFRD) is a frequent complication of cystic fibrosis, its prevalence increases with age of patient and is close to 30% at the age of 30 years. As life expectancy greatly increases, the number of cystic fibrosis patients developing diabetes will increase too. CFRD shares some features with type 1 and type 2 diabetes, initial phase is characterised by postprandial hyperglycaemia followed by a progression toward insulin deficiency. Insulin deficiency is an essential factor in the development of diabetes with an additional contribution of insulin resistance. Systematic screening with an oral glucose tolerance test is recommended from the age of 14 years because clinical signs of CFRD are often confused with signs of pulmonary infection and CFRD occurrence is associated with weight and pulmonary function deterioration. In observational studies CFRD diagnosis is associated with a significant increase in mortality, while treatment allow correction of weight and lung deterioration suggesting that CFRD has a significant impact on CF evolution. Microvascular complications are recognised, although paucity of data does not permit a clear description of their natural history. Annual screening for microvascular complication is recommended. There is no evidence by now that CF patients develop macrovascular complications. The only recommended pharmacological treatment is insulin therapy.
引用
收藏
页码:221 / 232
页数:12
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