My 13 year old daughter has what is known as cystic fibrosis related diabetes. What should I do when she gets high readings? What is a normal range for a child before and after meals?

Having diabetes on top of having cystic fibrosis is a big burden. You should be in close contact with your daughter’s cystic fibrosis team, and if you have not already done so, should consult with a pediatric diabetes team as well to figure out the best approach to treatment.

The general principles of cystic fibrosis related diabetes are the same as anyone else with diabetes and the degree of difficulty of treating the diabetes reflects how much residual insulin is still available. Decisions about food intake, premeal insulins, and monitoring are all important as are decisions about basal insulin availability, but all should be based on frequent monitoring of blood glucose levels. Normal values for cystic fibrosis patients and the same as for everyone else, approximately 70-100 mg/dl [3.9-5.6 mmol/L] premeals and up to 140 mg/dl [7.8 mmol/L] after meals with most home meters. However, you and your family as well as both specialty teams should work closely to define individual goals as well as hemoglobin A1c, lipid, kidney, blood pressure monitoring.

SB