CF Associated Conditions

Click below to see information about CF Diabetes or CF Arthritis

This information is from the CFF website:

Learn About CFRD

Cystic fibrosis-related diabetes (CFRD) occurs in over 30 percent of adults with CF. Women are diagnosed with CFRD more frequently than men.

While CFRD has some features in common with type 1 diabetes (usually childhood onset) and type 2 diabetes (usually adult onset), it also has important differences that require a different management approach. So it’s good to know the specifics of CFRD.

Let’s start with the most common warning signs of diabetes in CF:

  • Having to urinate (pee) more often
  • Being very thirsty and needing to drink often
  • Feeling very tired
  • Losing weight without trying or having a hard time gaining weight
  • Losing lung function that you and your CF care team can’t explain

If you are having a hard time keeping your weight up, have lost weight without any explanation or have an unexplained decline in lung function, you should talk with your CF team to be screened for diabetes.

What Is CFRD?

CFRD is caused by insulin insufficiency (not enough insulin). Insulin is a hormone that helps your body use food nutrients, allowing your cells to get all of the energy from the carbohydrates, protein and fat in the food you eat. Insulin is made in the pancreas in special cells called beta cells.

But CF can cause the cells in the pancreas to scar and not make insulin normally.

When there is not enough insulin available, people lose weight without trying (mostly muscle and fat stored in the body). This lack of insulin can also make lung function worse as high blood sugars can cause lungs to become more inflamed.

Be on the lookout for weight loss, since unexplained weight loss and a drop in lung function have been shown to occur 6 to 24 months before being diagnosed with CFRD.

Undiagnosed and untreated diabetes may shorten survival. Fortunately, treatment with insulin reverses muscle loss and helps with weight gain. It also improves survival.

The other symptoms (increased thirst, urinating more often, feeling tired) are caused by high blood sugar levels. It’s easy to miss these symptoms because people with CF often drink more (and then use the bathroom more) because of a dry mouth.

Myth Busters

“I can prevent CFRD if I watch my diet and don’t eat sugar.”

CFRD is not like type 2 diabetes, which typically runs in families and occurs more commonly in people who are inactive and overweight.

People with a family history of type 2 diabetes can prevent or delay diabetes by being active, eating healthy and keeping their weight in a healthy range. CFRD is not caused by diet, weight or lifestyle, and cannot be prevented.

This is why you need regular screening to detect CFRD as early as possible before it can cause problems with your weight and lung function.
Learn more about CFRD by watching the Cystic Fibrosis-Related Diabetes

CF Arthritis

– Information courtesy of the Canadian CF foundation

We often associate arthritis with older people with swollen knuckles and weak hips – not with children or young adults. But arthritis is now recognized as a complication of cystic fibrosis. Arthritis can start in childhood and occurs in 5-10% of people with cystic fibrosis.

Are there different types and causes of arthritis?

Two types of arthritis seem to be directly related to cystic fibrosis:

  • CF arthritis – also called ‘CF-associated arthritis’
  • hypertrophic pulmonary osteoarthropathy (HPOA).

Arthritis can result from the use of some of the medications frequently taken by people with cystic fibrosis. Often a part of the normal aging process, it can also occur when there is a family history of arthritis.
Arthritis is an immune disorder. CF arthritis and HPOA tend to worsen when the immune system is highly active and can flare up when a person with CF acquires a lung infection.

What are the symptoms?

CF arthritis, which can start when a person is young, generally occurs in episodes lasting less than a week at a time. These episodes may be accompanied by flu-like symptoms, rash and fever, which are likely to disappear between attacks.

HPOA in young adults begins with a gradual, constant ache that worsens over time. X-rays usually show some new bone formation. Tissue covering the bone may have ‘lifted’ from the bone surface. These bone formations can cause joint pain and ‘finger clubbing’ (a rounded, broad appearance of the fingertips and toes sometimes seen in people with cystic fibrosis). HPOA seems to occur when there is a chronic low oxygen level. It often worsens if lungs become infected or damaged. HPOA has been associated with cystic fibrosis, and several heart and lung disorders.

How are CF arthritis and HPOA treated?

CF arthritis can be treated satisfactorily with non-steroidal anti-inflammatory drugs (NSAIDs) – over-the-counter or prescription pain relievers. Generally, HPOA is treated with NSAIDs, physical therapy and, occasionally, corticosteroids. The damage caused by HPOA and even finger clubbing can be reversed when a person receives a lung transplant.

There is still no cure for arthritis pain, but we are learning more about it every year.