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March 24, 2008

Other, Other Illnesses

Question from Jonesboro, Arkansas, USA:

I just found out yesterday from my sister-in-law that my niece, her daughter, has been diagnosed with diabetes. She is seven years old and has had cystic fibrosis since she was six months old. My sister-in-law wasn't told by the family doctor exactly what kind or type of diabetes her daughter has yet because he wants to talk it over with her doctor at Le Bonheur Children's hospital in Memphis, Tennessee. They are very scared and all they have been told by others are bad stories about people going blind or even dying, which is what really scares us all. What can I tell them to ensure them that things are not going to be for the worst? My niece is a very sweet girl and deserves so much more. Do you know of any children with the same two diseases together?


It is somewhat early to have diabetes associated with cystic fibrosis for a seven-year-old, but one would need a lot more information to know what you are actually asking about. Is this just glucose intolerance? How often are the blood glucose levels abnormal? Do they respond to some simple dietary changes or not? The diabetes doctors at the Memphis Children’s Hospital are excellent and should be consulted, of course. They will want you to do a series of home blood glucose tests. We, for instance, would teach you how to use the simple home glucose monitors and get fingerstick blood glucose readings before and one to two hours after breakfast, lunch and dinner for about a week or two and then evaluate these results. With some special laboratory tests that we would then order, we could determine at what stage of glucose intolerance this is and what might be needed. The long term complications of diabetes are pretty miserable, but with modern treatment and monitoring, we believe that these can be postponed or totally avoided. The first order of business, however, is to decide what the blood glucose levels are running and then decide what treatment is needed, what monitoring is needed, etc.


[Editor’s comment: Individuals with cystic fibrosis who develop diabetes can be diagnosed with Cystic Fibrosis Related Diabetes (CFRD). For more information, see Diabetes mellitus and Paediatric cystic fibrosis related diabetes.