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People with CF can develop a type of diabetes called cystic fibrosis–related diabetes, which has features of both type 1 and type 2 diabetes, the most common types of diabetes. This becomes more common in people with CF as they get older. The diagnosis and treatment are not exactly the same for CFRD as they are for type 1 and type 2 diabetes. The answers below will provide more information about CFRD. Be sure to download the Managing CFRD Booklet.1

The information in this section is intended for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions you may have regarding a medical condition.

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Frequently asked questions about CFRD1,2

Generally speaking, what is diabetes?

Diabetes occurs when insulin, made in the pancreas, is either not made (type 1) or the body develops an abnormal response to insulin (type 2). People with diabetes do not change food into fuel very well. This can lead to:

  • Weight loss
  • Lack of energy
  • Difficulty fighting infections
What is insulin?

Insulin is a hormone made by the pancreas. Insulin works by helping proteins, fats, and sugars leave the blood and enter the cells where they are used for fuel.

How is CFRD different from other types of diabetes?

People with CF have insulin deficiency (type 1) and some patients develop insulin resistance (type 2). Chronic infections or high stress levels can cause insulin resistance, meaning the cells in the body do not use insulin the right way so more is needed to change food into fuel and keep blood sugar levels within the norm.

What are the symptoms of CFRD?

Frequent urination and constant thirst are typical signs of diabetes caused by high levels of sugar in the blood. Here are some additional common symptoms of CFRD to watch for:

  • Poor weight gain
  • Poor growth
  • Sudden decrease in lung function

These symptoms are non-specific, so early aggressive screening for CFRD is very important.1

How is CFRD diagnosed?

Starting at the age of 10, and any other time CFRD is suspected, an oral glucose tolerance test (OGTT) is recommended by the Cystic Fibrosis Foundation. For an OGTT:

  • You'll fast overnight (for 8 hours) before the test is given
  • Your blood will be taken to measure your baseline or fasting blood glucose level
  • You'll drink a glucose drink
  • Your blood will be taken 1 hour and 2 hours after you drink the glucose

If you think you have symptoms of CFRD, your pulmonologist and CF care team will help decide if you need an OGTT.

What is glucose?3

Glucose is the main type of sugar in the blood and is the major source of energy for the body's cells. Glucose comes from the foods you eat. Your body can make it from other substances as well. Glucose is passed from the cells through the bloodstream. Many hormones, including insulin, control glucose levels in the blood.

Once diagnosed with CFRD, will I have it forever?

Yes. Once diagnosed, you will always have CFRD.

How is CFRD treated?

CFRD is treated with insulin. Insulin allows sugars and proteins to move from the blood into the body's cells. It is used for energy and to build muscle.


If you think you have signs or symptoms of CFRD, talk with your pulmonologist and CF care team. They will help decide if you need to get tested. If you or a loved one develops CFRD, be sure to download and print the How to Manage CFRD booklet.

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References: 1. Zgherea D. CF related diabetes (CFRD) another CF complication to learn about. CF Connection Newsletter. 2. Cystic fibrosis-related diabetes. Cystic Fibrosis Foundation website. http://www.cff.org/livingwithcf/stayinghealthy/diet/diabetes/. Accessed May 1, 2016. 3. Glucose. KidsHealth website. http://kidshealth.org/parent/diabetes_center/words_know/glucose.html. Accessed May 1, 2016.
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