Factors unique to Cystic Fibrosis:

• Under nutrition
• Chronic inflamation with intermittent acute infection
• Glucagon* deficiency
• Altered gut nutrient absorption and transit time
• Liver disease
• Increased energy expenditure
• Thin, low lipid levels, normal blood pressure

What does this mean?

Under nutrition – Under nutrition makes it more important for Cystics to get all the nutrition their bodies need to survive. This includes carbohydrates.

Chronic inflammation with intermittent acute infection - Chronic infections can cause insulin resistance (like Type 2 diabetes). Blood glucose levels can go up as a result.

Glucagon* deficiency – *Glucagon is an important hormone involved in carbohydrate metabolism. Produced by the pancreas, it is released when the glucose level in the blood is low (hypoglycemia), causing the liver to convert stored glycogen into glucose and release it into the bloodstream.

CF causes glucagon deficiency, this is also a difference between CFRD and Type 1 diabetes. In Type 1, the pancreas is able to produce glucagon, so at times of hypoglycemia, Type 1 bodies are able to bounce back to a safer blood glucose level a little easier by the release of this chemical. With CFRD, the body is not able to produce enough glucagon, causing levels of hypoglycemia to stick around longer, or not rebound naturally. Hypoglycemia can cause a person to pass out, so this is a scary finding.

Altered gut nutrient absorption and transit time -This makes it hard to treat insulin resistance with oral medication.

Liver disease – Adds to the complications of diabetes. As well, it makes it hard to treat with oral medications, as liver disease is a side effect.

Increased energy expenditure – Making it ever more so important to have proper nutrition including carbohydrates!

Thin, low lipid* levels, normal blood pressure – *Lipids are broadly defined as any fat-soluble (lipophilic), naturally-occurring molecules, such as fats, oils, waxes, cholesterol, sterols, fat-soluble vitamins (such as vitamins A, D, E and K), monoglycerides, diglycerides, phospholipids, and others. The main biological functions of lipids include energy storage, acting as structural components of cell membranes, and participating as important signaling molecules.

Important points there are that lipids are used to transport vitamins and other nutrients and are also used for energy storage. What the effects of this on CFRD is, I am not quite sure. I guess that since there are less energy storing lipids, it is more important to get energy in via any means necessary, including insulin and carbohydrates.