Insulin Resistance in Cystic Fibrosis: Management

Abstract Cystic fibrosis-related diabetes is the most common comorbidity in subjects with cystic fibrosis. The hallmark of cystic fibrosis-related diabetes is the reduction of β-cell mass, leading to insulin insufficiency. However, insulin resistance (IR) may arise from decreased glucose uptake by muscle (peripheral IR) and through impaired suppression of hepatic glucose production (hepatic IR). Increased prevalence of overweight and obesity, sedentary lifestyle, high-calorie diets, fat-soluble vitamin deficiency, elevated oxidative stress, and increased life expectancy are reasons to believe that IR can achieve an important role in the development of glucidic disorders and macrovascular complications previously recognized in patients with cystic fibrosis. In this chapter we explain the principal mechanisms of IR in cystic fibrosis and propose preventive and nutritional management strategies for this problem.