TY - JOUR
T1 - Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity
T2 - A cases series and literature review
AU - Ahmed, Ammar
AU - Ankireddypalli, Anvitha
AU - Harindhanavudhi, Tasma
AU - Moran, Antoinette
AU - Moheet, Amir
N1 - Publisher Copyright:
© 2024
PY - 2024/12
Y1 - 2024/12
N2 - Cystic fibrosis-related diabetes (CFRD) is the most common non-pulmonary comorbidity in people with cystic fibrosis (CF). Current guidelines recommend insulin therapy as the treatment of choice for people with CFRD. In the past, obesity and overweight were uncommon in individuals with CF. However, in recent years, advancements in CF therapies have led to a significant increase in the prevalence of overweight and obesity within this population. Glucagon-like peptide1 receptor agonist (GLP-1 RA) therapies could potentially improve glycemic control in people with CF by increasing insulin secretion, slowing gastric emptying, and promoting weight loss through central appetite suppression, which in turn can enhance insulin sensitivity. We report, for the first time, five cases of individuals with CFRD complicated by obesity treated with GLP 1-RA for at least two years. With GLP 1-RA therapy, 4 out of 5 individuals exhibited weight reduction ranging from 7% to 19% over two years, while forced expiratory volume in 1 s (FEV1)/predicted FEV1 % remained stable or improved in all cases. The impact on glycemic control was variable. Insulin requirements either reduced or remained stable in all five cases. Overall, GLP-1 RA was well tolerated in this case series; one individual discontinued the medication after two years of therapy due to poor appetite and nausea.
AB - Cystic fibrosis-related diabetes (CFRD) is the most common non-pulmonary comorbidity in people with cystic fibrosis (CF). Current guidelines recommend insulin therapy as the treatment of choice for people with CFRD. In the past, obesity and overweight were uncommon in individuals with CF. However, in recent years, advancements in CF therapies have led to a significant increase in the prevalence of overweight and obesity within this population. Glucagon-like peptide1 receptor agonist (GLP-1 RA) therapies could potentially improve glycemic control in people with CF by increasing insulin secretion, slowing gastric emptying, and promoting weight loss through central appetite suppression, which in turn can enhance insulin sensitivity. We report, for the first time, five cases of individuals with CFRD complicated by obesity treated with GLP 1-RA for at least two years. With GLP 1-RA therapy, 4 out of 5 individuals exhibited weight reduction ranging from 7% to 19% over two years, while forced expiratory volume in 1 s (FEV1)/predicted FEV1 % remained stable or improved in all cases. The impact on glycemic control was variable. Insulin requirements either reduced or remained stable in all five cases. Overall, GLP-1 RA was well tolerated in this case series; one individual discontinued the medication after two years of therapy due to poor appetite and nausea.
KW - CFRD
KW - CFTR modulators
KW - Cystic fibrosis
KW - Cystic fibrosis-related diabetes
KW - Obesity
KW - Semaglutide
UR - http://www.scopus.com/inward/record.url?scp=85208492826&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85208492826&partnerID=8YFLogxK
U2 - 10.1016/j.jcte.2024.100375
DO - 10.1016/j.jcte.2024.100375
M3 - Review article
C2 - 39764279
AN - SCOPUS:85208492826
SN - 2214-6237
VL - 38
JO - Journal of Clinical and Translational Endocrinology
JF - Journal of Clinical and Translational Endocrinology
M1 - 100375
ER -