Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review

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, i...

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Main Authors: Ammar Ahmed, Anvitha Ankireddypalli, Tasma Harindhanavudhi, Antoinette Moran, Amir Moheet
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Clinical & Translational Endocrinology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214623724000462
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author Ammar Ahmed
Anvitha Ankireddypalli
Tasma Harindhanavudhi
Antoinette Moran
Amir Moheet
author_facet Ammar Ahmed
Anvitha Ankireddypalli
Tasma Harindhanavudhi
Antoinette Moran
Amir Moheet
author_sort Ammar Ahmed
collection DOAJ
description 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.
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publishDate 2024-12-01
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spelling doaj-art-1b8c0b89c6ea4af8a3ac5f6cb288602d2025-08-20T02:50:27ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372024-12-013810037510.1016/j.jcte.2024.100375Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature reviewAmmar Ahmed0Anvitha Ankireddypalli1Tasma Harindhanavudhi2Antoinette Moran3Amir Moheet4Division of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Corresponding author.Division of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USADivision of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USADivision of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USADivision of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USACystic 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.http://www.sciencedirect.com/science/article/pii/S2214623724000462Cystic fibrosis-related diabetesCystic fibrosisCFRDSemaglutideObesityCFTR modulators
spellingShingle Ammar Ahmed
Anvitha Ankireddypalli
Tasma Harindhanavudhi
Antoinette Moran
Amir Moheet
Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review
Journal of Clinical & Translational Endocrinology
Cystic fibrosis-related diabetes
Cystic fibrosis
CFRD
Semaglutide
Obesity
CFTR modulators
title Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review
title_full Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review
title_fullStr Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review
title_full_unstemmed Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review
title_short Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review
title_sort glucagon like peptide1 receptor agonist treatment of cystic fibrosis related diabetes complicated by obesity a cases series and literature review
topic Cystic fibrosis-related diabetes
Cystic fibrosis
CFRD
Semaglutide
Obesity
CFTR modulators
url http://www.sciencedirect.com/science/article/pii/S2214623724000462
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