Cystic fibrosis related diabetes

Question

My son, aged 28, has just been told that he should receive a treatment for diabetes in the near future (within a year, more or less) and then be hospitalized for 15 days to control treatment.
What about this treatment, inconvenience, devices to carry everywhere (is it light weight, discrete), insulin conservation (refrigerator…)?
He is very concerned about this increase in care.
Thank you in advance for your reply.

Answer

First, cystic fibrosis related diabetes is very common in adult patients with cystic fibrosis who have exocrine pancreatic insufficiency (treated with pancreatic enzymes), because lesions of the pancreas gradually affect the cells which secrete insulin (islets of Langerhans). This is often a slow process, but diabetes may occur earlier if respiratory infection is poorly controlled.
The standard treatment is insulin. Initial treatment generally consists of subcutaneous injections of insulin before the three main meals. The possibility of starting treatment with tablets (Repaglinide) that stimulate residual insulin secretion, over a transitional period before the insulin, is being evaluated in patients with good condition.
The hospitalization of a few days is intended to educate patients to diabetes monitoring and treatment modalities adapted to the results of blood glucose and feeding.

Your son will have to carry with him:
- A blood glucose meter (small lightweight device that fits in the hand) in order to measure fasting blood sugar and blood glucose after meals. The meter analyzes a drop of blood taken from the fingertip. It is obtained by pricking the skin with a lancet and is placed on a test strip or an electrode that the meter reads and uses to calculate the blood glucose level. Then the meter displays the glucose blood level. The recent blood glucose meters allow, using software, to download blood glucose levels on the computer.
- Insulin if this treatment has been prescribed. Insulin used daily can be stored at room temperature, between 18 and 25 º C and retains for a period of a month. However, the reserves of insulin must be stored between 2 ° and 15 °C but should not be frozen. It is important to avoid exposing insulin to extreme temperatures: cold winter and hot summer days. Cotton and alcohol are not essential to the injection technique, and clean skin is enough.
- Sugar that will be absorbed quickly in case of hypoglycemia.

It is normal that your son feels concerned because of diabetes: when it is diagnosed, it is felt as a second difficult disease to manage. In practice, thanks to the education given to patients, habits are made quickly and it becomes lighter than what was initially feared.
Good diabetes care also allows to feel better and to ensure that the cystic fibrosis lung disease is more tightly controlled, providing a real benefit.

Best regards.
Dr Dominique Hubert

20.09.2011