Diabetes Mellitus and Bone Disease in Cystic Fibrosis

Curran, David; McArdle, John R.; Talwalkar, Jaideep S.

doi:10.1055/s-0029-1238910

Cited by 11 publications

(10 citation statements)

References 129 publications

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“…People with CF have multiple risk factors for inadequate bone mineralisation . Longitudinal studies have shown that bone gains during puberty are decreased in CF adolescents compared with healthy controls, resulting in decreased attainment of peak bone mass . A meta‐analysis reported that in CF, the prevalence of osteoporosis and osteopenia was 23.5% and 38%, respectively .…”

Section: Musculoskeletal Complications Of Cfmentioning

confidence: 99%

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline

et al. 2016

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Physiotherapy management is a key element of care for people with cystic fibrosis (CF) throughout the lifespan. Although considerable evidence exists to support physiotherapy management of CF, there is documented variation in practice. The aim of this guideline is to optimize the physiotherapy management of people with CF in Australia and New Zealand. A systematic review of the literature in key areas of physiotherapy practice for CF was undertaken. Recommendations were formulated based on National Health and Medical Research Council (Australia) guidelines and considered the quality, quantity and level of the evidence; the consistency of the body of evidence; the likely clinical impact; and applicability to physiotherapy practice in Australia and New Zealand. A total of 30 recommendations were made for airway clearance therapy, inhalation therapy, exercise assessment and training, musculoskeletal management, management of urinary incontinence, managing the newly diagnosed patient with CF, delivery of non‐invasive ventilation, and physiotherapy management before and after lung transplantation. These recommendations can be used to underpin the provision of evidence‐based physiotherapy care to people with CF in Australia and New Zealand.

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Section: Musculoskeletal Complications Of Cfmentioning

confidence: 99%

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline

et al. 2016

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“…Despite the extensive scarring and destruction of the pancreas, the b-islet cells are relatively preserved initially. However, as patients become older, fibrosis of the islets occurs, resulting in a reduction in the number of insulin producing cells (10). This loss of insulin producing cells and relative insulin deficiency is the primary cause of CFRDM.…”

Section: Diseases Of Aging In Cystic Fibrosis: Diabetes Osteoporosismentioning

confidence: 99%

“…Hemoglobin A1c (HgbA1c) is not generally useful for screening (10). HgbA1c levels might not be elevated early in CFRDM due to the predominantly postprandial nature of the disease.…”

Section: Diseases Of Aging In Cystic Fibrosis: Diabetes Osteoporosismentioning

confidence: 99%

“…These measures are also useful adjuncts for blood sugar control for those patients with CFRDM. Currently, oral hypoglycemics have not been demonstrated to be useful for treatment of CFRDM (10). However, further studies are warranted, especially as new and novel oral hypoglycemics are developed for use in type 2 diabetes.…”

Section: Diseases Of Aging In Cystic Fibrosis: Diabetes Osteoporosismentioning

confidence: 99%

“…Bisphosphonates should be utilized for treatment of patients with severely reduced BMD (T-or Z-score --2.0), and in patients with a more mildly reduced BMD (T-or Z-score --1.0)-2.0), if fragility fractures have occurred, or the patient has rapidly declining BMD, or is awaiting lung transplant. Oral agents are preferred to IV bisphosphonates, because they are equally efficacious, but have a lower risk of significant side effects, primarily post-infusion bone pain for IV bisphosphonates (10). Teriparatide, a synthetic human parathyroid hormone, administered subcutaneously, can be utilized to increase BMD in patients with osteoporosis, and can be useful for some CF patients with severe osteoporosis (18).…”

Section: Diseases Of Aging In Cystic Fibrosis: Diabetes Osteoporosismentioning

confidence: 99%

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Caring for adults with cystic fibrosis

Anstead

2010

International Journal on Disability and Human Development

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Adults with cystic fibrosis (CF) will soon outnumber children, thus CF is a disease that adult and pediatric physicians must understand. Adults with CF face a very difficult challenge: to have a career and/or a family while still finding the time to keep up the often demanding treatment regimen required to maintain their health in the face of a complicated multisystem disease, such as CF. It is our duty as physicians to help them meet this challenge by providing effective and compassionate care. More and more effective treatments for CF are gradually becoming available that will markedly enhance the quality of life and improve survival for patients with CF. Intelligently integrating these new therapies with existing therapies to minimize treatment burden while maximizing the benefit of these therapies to maintain lung function and prolong life is perhaps the greatest challenge we face as CF caregivers. It is a wonderful challenge to face for CF patients and their caregivers.

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Managing treatment complexity in cystic fibrosis: Challenges and Opportunities

Sawicki

Tiddens

2012

Pediatric Pulmonology

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Cystic fibrosis (CF) is a complex, chronic, multisystem disease for which there is currently no cure. Nonetheless, advances in management have led to dramatic improvements in patient survival. With this development, new issues have arisen for CF patients and their care providers, including an increased symptom burden and increased frequency of co-morbidities as patients reach older ages, leading to the need for a highly complicated and time-consuming regimen of treatments. Such high symptom and treatment burden often leads to non-adherence and low levels of competence with administration of therapy, both of which may have detrimental impacts on CF outcomes. Optimal management is also hindered by other patient-related factors, including inadequacies in disease education which may lead to issues with self-management. This is particularly important during the transition from parent-directed therapy to independent self-management that occurs during adolescence and early adulthood. Clinicians are also faced with a considerable challenge when selecting interventions for individual patients; although the paradigm of aggressive care necessitates a wide range of therapies, there is a limited evidence base with which to compare available therapeutic regimens. Novel pharmacological agents are being developed to target the underlying cause of CF, while non-pharmacological interventions aim to improve competence and maximize adherence and health outcomes. Comparative effectiveness research is needed to simplify management and facilitate the implementation of appropriate treatment strategies.

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Diabetes Mellitus and Bone Disease in Cystic Fibrosis

Cited by 11 publications

References 129 publications

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline

Caring for adults with cystic fibrosis

Managing treatment complexity in cystic fibrosis: Challenges and Opportunities

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