Update on cystic fibrosis-related diabetes

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Andrea Kelly, MD MSCE Division of Pediatric Endocrinology & Diabetes Children’s Hospital of Philadelphia Perelman School of Medicine at University of Pennsylvania.
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Update on cystic fibrosis-related diabetes Andrea Kelly, Antoinette Moran  Journal of Cystic Fibrosis  Volume 12, Issue 4, Pages 318-331 (July 2013) DOI: 10.1016/j.jcf.2013.02.008 Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions

Fig. 1 Incretin secretion and action. Glucose, fructose, free fatty acids, and to a lesser extent amino acids stimulate GLP-1 and GIP secretions. GLP-1 and GIP augment glucose stimulated insulin secretion and in animal models inhibit β-cell apoptosis and promote β-cell proliferation. GIP also promotes lipogenesis. GLP-1 suppresses glucagon secretion and delays gastric emptying. Journal of Cystic Fibrosis 2013 12, 318-331DOI: (10.1016/j.jcf.2013.02.008) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions

Fig. 2 Plasma glucose and C-peptide in healthy controls (●), pancreatic sufficient CF (Ο), pancreatic insufficient CF without CFRD (▲), and CFRD (◊), adapted from Moran et al. [16]. Journal of Cystic Fibrosis 2013 12, 318-331DOI: (10.1016/j.jcf.2013.02.008) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions

Fig. 3 Enzyme replacement improves glucose excursion and increases GLP-1 and GIP secretion in CF. Plasma glucose (A), GLP-1 (B), and GIP (C) following a mixed meal tolerance test in healthy controls (▲), CF without enzymes (Ο) CF with enzymes (●), adapted from Kuo et al. [31]. Journal of Cystic Fibrosis 2013 12, 318-331DOI: (10.1016/j.jcf.2013.02.008) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions

Fig. 4 Mortality in CF subjects with and without CFRD, from Moran et al. [50]. Blue line: males, red line: females; solid line: CFRD; dashed line: CFRD. Journal of Cystic Fibrosis 2013 12, 318-331DOI: (10.1016/j.jcf.2013.02.008) Copyright © 2013 European Cystic Fibrosis Society. Terms and Conditions