Posted by Nichole on December 31, 2008 at 09:59:35:
In Reply to: ! posted by Adam on December 30, 2008 at 19:44:29:
I don't think you need to worry too much about diabetes being part of the problem. To my knowledge cfrd doesn't cause a lot of the typical diabetes problems such as bad circulation, poor eyesight, and eventually neuropathy.
I've had cfrd for six years and I recently moved to a new clinic where the endocrinologists actually KNOW SOMETHING about cfrd. Not only that, but finally someone was able to explain it to me in a way that makes sense....
In type 1 diabetes, the body attacks ALL of the islet cells which are responsible for making insulin. In type 2, the body makes insulin, the body just becomes resistant to it due to poor health and genetics.
The islet cells are in the pancreas, and let's face it, us CFers don't have the best pancreases. Over time our pancreases become more damaged, and that includes the islet cells. So over time, we produce less and less insulin. HOWEVER, we are still producing some insulin, which supplies us with out basal rate. But you need both a basal and a bolus. A bolus is the quick burst of insulin we get when we eat something high in carbs. People with cfrd aren't capable of producing the bolus, or at least not enough of one, on their own since they don't have a fully functioning set of islet cells.
So those of us lucky enough to have cfrd, get high blood sugar with the intake of carbohydrates. But since we produce SOME insulin, our body keeps pumping it out, slowly, but surely, until our blood sugars level back out. That's why the A1C isn't a good indicator of how our diabetes is doing overall.
Another factor is infection. When people are sick (not just people with cf), our bodies become resistant to insulin. CFers are basically fighting infection all of the time which means that we are resistant to the little bit of insulin we are producing. And that is why people with cfrd experience more blood sugar problems during on exacerbation.
So cfrd sucks, and it can make you feel tired and cranky if you don't manage it, but it's not going to cause the same kind of damage that either type 1 or 2 does since our blood sugars are never very high for a way extended period of time.
As far as cold feet go, I've always had super clammy hands and feet. Not sure why. I've heard before that people with cf sweat a bit more than the average person but I can't remember where I heard that so I can't verify it.