My 21 year old daughter has cystic fibrosis along with pancreatitis, and has now been diagnosed with diabetes. I’m concerned that the diet for diabetes and that of her cystic fibrosis will not work together. Any suggestions? Also, any information you have on CF and diabetes would be greatly appreciated!

As young people with cystic fibrosis now survive into adulthood, diabetes has become an increasingly common complication. When you think of it though, there is no real conflict between the dietary approaches. You will, I am sure. already be familiar with three day diet records and computerised assessment of intake and with the variations of intake with sick days, etc. The addition of diabetes doesn’t mean any change in management, but rather the need to acquire skills in adjusting insulin dose appropriately to the actual food intake. I expect your daughter is already on bedtime Lantus (insulin glargine) for her basal insulin needs so that what you have to adapt to is the ability to modify the meal time lispro according to the premeal blood sugar and to the ‘carb’ content of the meal.

Its rather beyond the scope of an e-mail to explain all this in any detail, but I think you would be helped by getting a copy of Managing Cystic Fibrosis Related Diabetes by Dana Hardin and others, which is available without charge from The Cystic Fibrosis Foundation.

I hope this will help start you on the right track.

DOB

[Editor’s comment: Also see Diabetes mellitus and cystic fibrosis: Comparison of clinical parameters in patients treated with insulin versus oral glucose-lowering agents.

SS]