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CF diabetes

Question
Dear expert team,
I have a general question:
is it possible to avoid a CF diabetes via an optimal nutrition or possibly delay its onset?
We live on wholefood, and I produce anything that is possible, myself. We avoid all "hidden" sugars (e.g. in completed products). Sweets are still allowed, however very restricted. This is however not a problem for my son (CF patient, 8 years old). My next purpose would be to replace also the sweets via healthy food with "healthy sugar alternatives".
In the end, we avoid all, that leads to a fast increase of the blood sugar.

Is it possible that we might have success with this kind of nutrition to delay or even avoid a CF diabetes?
Actually, there is no hint for a CF diabetes in my son. In the long runs, however, I am worrying.
Many thanks for your efforts,
Answer
Hello,
you direct a very interersting topic because you ask, if one could avoid the onset of a CF diabetes or at least delay the onset via an optimal nutrition. You report, that you try in the nutrition of your 8-year-old son, to avoid as completely as possible hidden sugars and that you try to avoid massive increases of the blood sugar via the nutrition. Now you consider, to eliminate also the few sweets for your son, and to replace them by "healthy sugar alternatives".
In general one has to be said to the question, that due to a lack of corresponding studies, we can not say exactly in how far the by you chosen nutrition can have an influence on the fact if and when your son is developing a diabetes. In general it is true, that only CF patients who are pancreatic insufficient, have a risk, to develop a CF diabetes. It can be assumed, that the way of nutrition has an influence on it, when the diabetes starts. Such a developement of a diabetes is however in general not avoidable. This is because after the actual knowledge, the destruction of the exocrine pancreas and the consecutive developement of scars in the pancreas leads in the end also to a damage of the endocrine pancreas, that is responsible for the regulation of blood sugar via insulin secretion.
As pancreatic insufficient patients develop a diabetes at very different ages, one has to assume, that many different factors are responsible for the onset of a diabetes. It is known for sure today, that a cortisone treatment can support the early onset of a diabetes in CF. Cortisone containing drugs should therefore only be used according to a strict indication in CF.
As you know, a high-calory diet is urgently needed in CF. In here, a balanced part of carbohydrates is needed. This part you should for sure take into account in your nutrition. Sweets in small amounts are part of eating- and life quality and should therefore be allowed to a certain extent.
Therefore it would not be possible to avoid in general the development of a diabetes via your exemplary behaviour. You should always be aware, that such a diabetes can well be treated today and if it is well treated, it represents in no way a risk for a shorter lifespan of your son.
You therefore do everything very well. I wish you and your family much luck.
Best regards,
Dr. H.-G. Posselt
16.01.2017