Tuesday, November 18, 2008

CF & Gestational Diabetes

I recently learned on the CF forums that women with CF are at greater risk of developing gestational diabetes. There is some great information in the thread here. I was aware the general CF population is at risk for developing diabetes - it is called CF related diabetes (CFRD), because it is caused by CF related damage to the pancreas.

I did a little bit of online research, and here is my understanding of gestational diabetes in a CFer:
  • The CF foundation describes the difference between CFRD and "regular" (Types 1 & 2) diabetes on their website. Basically, CFRD is a combination of Types 1 & 2 diabetes - the pancreas does not release enough insulin, and the body is resistant to insulin (due to constantly battling infections). 43% of adult CFers over the age of 30 have CFRD.
  • CFRD seems to be more common in CFers who are pancreatic insufficient (PI). (Pancreatic insufficiency happens when channels that secret digestive enzymes are blocked by mucus. A PI CFer must take digestive enzymes in pill form when they eat.) However, I don't think this means pancreatic sufficient (PS) CFers are not at risk for developing CFRD. Although PS CFers do not need to take digestive enzymes, there is still sometimes damage to the pancreas that occurs. For example, PS CFers are at a greater risk of developing pancreatitis (I suffered from this a few years ago). Therefore, it is my educated guess that even PS CFers are at some risk for developing CFRD.
  • The American Diabetes Association's website describes gestational diabetes. Gestational diabetes is similar to type 2 diabetes in that the body is resistant to insulin. They aren't 100% sure of the cause of gestational diabetes, but think it may have something to do with pregnancy hormones "blocking the action of insulin in the mother's body." 4% of "normal" pregnant women will get gestational diabetes.
  • I could not find many sources regarding the risk of gestational diabetes in women with CF. One study saw a rate of 14% (7 out of 49 patients). Another study found 7 out 8 pregnant CFers developed gestational diabetes.
So, it seems the risk of CFRD combined with the risk of gestational diabetes means this is something every CFer who is TTC should discuss with their doctor. I know I am going to ask mine about it at my next appointment!


Alicia said...

You have such an interesting blog. I read it regularly (have it in my google reader), and I will try to become better about posting comments! So I read it right that you are pancreatic sufficient? Do you mind telling me which CF genes you have? Forgive me if you've explained that somewhere. I hope you get to realize your dreams of pregnancy!

Alicia said...

I meant to say which gene mutations...

Jess said...

I have A LOT of questions too at my next CF appointment about TTC! Eventhough we've done the genetic testing and my husband isn't a carrier, it seems harder for us. I could definitely use some encouraging words from the docs :)

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