Читать книгу Clinical Dilemmas in Diabetes - Группа авторов - Страница 61

Diabetes is the most common extra‐pulmonary complication of cystic fibrosis and rises with age so that 50% of affected patients over age 30 have diabetes [51]. There is a recognized abnormality in insulin secretion which is likely explained by the actions of the Cystic Fibrosis Transmembrane Regulator (CFTR) on β‐cell electrophysiology. Drugs that improve CFTR function also have salutary effects on insulin secretion [52]. Exocrine pancreatic insufficiency may decrease intraluminal release of nutrients that stimulate incretin hormone secretion and delay gastric emptying thereby contributing to postprandial hyperglycemia. Endocrine dysfunction is also strongly correlated with destruction of the exocrine pancreas.

Nutritional deficiency and also the systemic inflammation associated with cystic fibrosis likely impair insulin action which is also a feature of Cystic Fibrosis‐related Diabetes. Macrovascular complications are uncommon and microvascular complications occur at lower rates than they do in “classical” type 1 and type 2 diabetes [53].