This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Nearly 75% of patients with CF have impaired glucose tolerance and 15% have frank diabetes, called CF related diabetes or CFRD. This is caused by a combination of insulin resistance and insulin deficiency. The 1998 CF Foundation Consortium recognized 4 major categories of glucose tolerance in CF: 1) Normal glucose tolerance (FBG <126; pp <150); 2) Impaired glucose tolerance (FBG <126; pp 151-200); 3) Diabetes w/o fasting hyperglycemia (FBG <126; pp >200), a type of impaired glucose tolerance. 4) Diabetes with fasting hyperglycemia. Only patients who have CFRD with FH routinely receive insulin treatment. The most effective insulin regimen for CFRD is multi-insulin injections around the time of meals (generally 3-5 shots per day). Many CF patients have been reluctant to take this large number of insulin injections. We hypothesize use of the insulin pump will provide effective therapy for patients with CF related diabetes (CFRD) with fasting hypergycemia (FH) and CFRD without FH by improving body weight, lean body mass, whole body protein turnover, hepatic glucose production (HGP), and blood sugar control.
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