Cystic Fibrosis-Related Diabetes (CFRD) Module Reflection:
The CFRD module has significantly expanded my understanding of the complexities of cystic fibrosis-related diabetes. Before this module, I had a general awareness of CFRD, but I did not fully grasp the extent of its prevalence. I was particularly interested in this module because of its relationship with the endocrine system.
One of the key takeaways for me was recognizing that CFRD is different from diabetes. I learned that insulin insufficiency is due to damage to the pancreas, with variable contributions from insulin resistance, especially during periods of illness. Understanding this helped clarify why insulin is the standard and most effective treatment rather than oral hypoglycemic agents. I also appreciated the emphasis on early detection through annual oral glucose tolerance testing (OGTT) at an early age, which underscores the importance of proactive screening in maintaining nutritional and pulmonary health.
The module also deepened my appreciation for the individualized nature of CFRD management. I was particularly struck by how insulin needs can be individualized, ranging from occasional use during illness or tube feeding to full basal-bolus regimens or insulin pump therapy. From a nutrition standpoint, it was valuable to learn that carbohydrate restriction is not typically advised in CF due to the high-calorie demands of the condition. However, managing the type and timing of carbohydrate intake, especially in the context of reactive hypoglycemia, requires careful education and planning. Tools such as carbohydrate counting, continuous glucose monitoring (CGM), and smart insulin technologies can play a vital role in care. Another area that stood out was the shift toward individualized, nutrient-dense dietary counseling, as opposed to the traditional high-fat, high-calorie diet, which reflects the evolving needs of this population. It reinforced the importance of ongoing reassessment and education tailored to both metabolic needs and patient goals.
Overall, this module enhanced both my clinical knowledge and strengthened my practical approach to managing patients with CFRD. It reinforced the importance of personalized nutrition care, the role of technology in diabetes management, and the critical need for early detection and monitoring. I’m excited about learning more about the endocrine system and its role in CFRD. As a future dietitian, I feel more equipped and knowledgeable to address the challenges facing individuals with CF and CFRD, and to contribute meaningful care within an interdisciplinary team.
