<P> Newborns with intestinal obstruction typically require surgery, whereas adults with distal intestinal obstruction syndrome typically do not . Treatment of pancreatic insufficiency by replacement of missing digestive enzymes allows the duodenum to properly absorb nutrients and vitamins that would otherwise be lost in the feces . However, the best dosage and form of pancreatic enzyme replacement is unclear, as are the risks and long - term effectiveness of this treatment . </P> <P> So far, no large - scale research involving the incidence of atherosclerosis and coronary heart disease in adults with cystic fibrosis has been conducted . This is likely because the vast majority of people with cystic fibrosis do not live long enough to develop clinically significant atherosclerosis or coronary heart disease . </P> <P> Diabetes is the most common nonpulmonary complication of CF . It mixes features of type 1 and type 2 diabetes, and is recognized as a distinct entity, cystic fibrosis - related diabetes . While oral antidiabetic drugs are sometimes used, the recommended treatment is the use of insulin injections or an insulin pump, and, unlike in type 1 and 2 diabetes, dietary restrictions are not recommended . </P> <P> There is no strong evidence that people with cystic fibrosis can prevent osteoporosis by increasing their intake of vitamin D. Bisphosphonates taken by mouth or intravenously can be used to improve the bone mineral density in people with cystic fibrosis . When taking bisphosphates intravenously, adverse effects such as pain and flu - like symptoms can be an issue . The adverse effects of bisphosphates taken by mouth on the gastrointestinal tract are not known . </P>

How many strains of cystic fibrosis are there