Insulin and oral agents for managing cystic-fibrosis related diabetes

Cystic fibrosis is a serious genetic disorder damaging the lungs and pancreas (an organ essential for sugar metabolism). People with cystic fibrosis need high calorie diets to manage breathing difficulties resulting from their lung damage; optimizing sugar metabolism is, therefore, an important therapeutic goal. Adequate sugar metabolism is linked to outcome measures such as managing breathing difficulties and maintaining ideal body weight. We were only able to include one randomized trial which met the inclusion criteria (post-meal glucose control) in this review. This trial was short term (five hours post-meal) with only seven participants with cystic fibrosis-related diabetes who had normal fasting blood sugars. The trial reported significant results in favour insulin over repaglinide for blood glucose levels at five hours post-meal, but the amounts of insulin and repaglinide received were not comparable and this may lead to bias in the results. A small number of cases of hypoglycemia were reported, but these were resolved without further treatment.