The link between cystic fibrosis and diabetes explained

Cystic fibrosis-related diabetes (CFRD) is somewhat of an anomaly to medical experts, as it has characteristics of both type 1 and type 2 diabetes.

According to research from Lund University, many people with cystic fibrosis (CF) develop diabetes. But the reasons for this link have been largely unknown – until now.

A new study has identified a molecular mechanism that can contribute to higher diabetes risk, whereas before the risk for diabetes in people with CF was explained by damage to the pancreas.

"We are the first research group to show that the mutated gene that causes cystic fibrosis also plays an important role in the release of insulin," Anna Edlund, a doctoral student at Lund University Diabetes Centre, said in a news release. "The risk of diabetes is not only explained by the destruction of the pancreas."

Insulin release is 'insufficient' in CF patients

The researchers explained that CF comes from a genetic mutation in an ion channel that is supposed to regulate the transport of salt in lung and pancreas cells. This mutation, the team found, also inhibits the secretion of insulin into the blood.

"Normally, insulin is released in two stages: The early stage is a rapid response to raised blood sugar, and the later stage aims to restore blood sugar levels," Edlund said. "In cystic fibrosis, the early stage of insulin release in particular is insufficient."

The results of the study correspond with clinical observations, the team said, where patients with CF who don't have diabetes have normal blood sugar in a fasting state but high blood sugar after eating.

Understanding the mechanisms

Lena Eliasson, professor at Lund University Diabetes Centre, said the study provides the first piece of evidence that links CF to insulin secretion.

"Despite being common among cystic fibrosis patients, surprisingly little is known about the mechanisms behind diabetes in this group of individuals," Eliasson explained. "We need to know what causes the problem in order to develop preventive treatments that improve the cells' ability to secrete insulin."

By the age of about 30, one in four people with CF also has diabetes that requires insulin treatment, the press release stated. And while many CF patients can now live longer lives, the condition is still fatal.

Results of the study are published in BMC Medicine.

Source: BioMed Central

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