Robert J J, Mosnier-Pudar H
Hôpital Necker-Enfants Malades, Paris.
Rev Mal Respir. 2000 Aug;17(3 Pt 2):798-801.
As their life expectancy has improved, patients with cystic fibrosis have experienced an increasing incidence of diabetes. Diabetes mellitus is characterized by improved and delayed insulin secretion, normal insulin sensitivity, and it is most often accompanied by exocrine pancreatic insufficiency. The development of diabetes mellitus is insidious and symptomless, and the overall cystic fibrosis status deteriorate for years prior to the diagnosis of diabetes. Since insulin therapy seems to revert deterioration for years of clinical status, and since late diabetic complications may develop, diabetes mellitus in cystic fibrosis should be identified by screening with an OGTT from the age of 15 years, and treated with insulin from the time of diagnosis of diabetes.
随着囊性纤维化患者预期寿命的延长，其患糖尿病的发病率呈上升趋势。糖尿病的特征是胰岛素分泌改善但延迟、胰岛素敏感性正常，且最常伴有外分泌性胰腺功能不全。糖尿病的发展隐匿且无症状，在糖尿病诊断前数年，整体囊性纤维化病情就已恶化。由于胰岛素治疗似乎能逆转数年临床状态的恶化，且可能会出现晚期糖尿病并发症，因此囊性纤维化患者的糖尿病应从15岁起通过口服葡萄糖耐量试验（OGTT）进行筛查，并在糖尿病诊断时即开始用胰岛素治疗。
