Women with cystic fibrosis-related diabetes mellitus are likely to be treated with insulin before conception, require caesarean section, and be admitted to the hospital due to cystic fibrosis exacerbations, according to a new review article published in Diabetes Therapy.

“Our review highlights the importance of good glucose control, stable cystic fibrosis before pregnancy and a multidisciplinary team approach,” Recie Davern, MD, and the coauthors of the review wrote.

With the life expectancy of cystic fibrosis patients improving, the number of pregnancies in these patients is also increasing. This brings with it an increased risk of cystic fibrosis-related diabetes mellitus.

Here, a team of researchers from Ireland, the country with the highest incidence of cystic fibrosis worldwide, retrospectively reviewed pregnancy outcomes for both mothers and babies in women affected by cystic fibrosis-related diabetes mellitus who attended the National Maternity Hospital in Dublin between 2015 and 2019.

Read more about cystic fibrosis comorbidities

During this time period, 12 women had cystic fibrosis-related diabetes mellitus. These 12 women had a total of 15 pregnancies, and in 10 of them, diabetes mellitus was diagnosed before conception. The researchers found that the median weight of the babies at birth was lower in women diagnosed with cystic fibrosis-related diabetes mellitus before conception than in women diagnosed after conception (2.8 kg vs 3.02 kg).

The median weight gain during pregnancy was also lower in women diagnosed with cystic fibrosis-related diabetes mellitus before conception than in those diagnosed after conception (10.9 kg vs 11.9 kg). More than half (62.5%) of women diagnosed with cystic fibrosis-related diabetes mellitus before conception had a caesarean section.

The majority of women diagnosed with cystic fibrosis-related diabetes mellitus were admitted to the hospital due to cystic fibrosis exacerbations during their pregnancies, but this was even more common in women diagnosed before conception than in those diagnosed during pregnancy (87.5% vs 75%).

“More research is needed in this area,” the authors concluded.

Reference

Davern R, Balan G, Kilcoyne C, et al. Cystic fibrosis-related diabetes mellitus and pregnancy: a retrospective study. Diabetes Ther. Published online February 21, 2022. doi:10.1007/s13300-022-01223-1