Semaglutide in Cystic Fibrosis-Related Diabetes

Abstract Context and Objective In spite of the evidence that inadequately controlled glycemia is associated with worse clinical outcomes, cystic fibrosis-related diabetes (CFRD) is not well controlled in a majority of patients. The objective of this report is to demonstrate the effect of the additio...

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Published in:	The journal of clinical endocrinology and metabolism Vol. 105; no. 7; pp. 2341 - 2344
Main Authors:	Gnanapragasam, Helen, Mustafa, Naghma, Bierbrauer, Mary, Andrea Providence, Tara, Dandona, Paresh
Format:	Journal Article
Language:	English
Published:	US Oxford University Press 01-07-2020 Copyright Oxford University Press
Subjects:	Blood Glucose - analysis Care and treatment Case studies Complications and side effects Cystic fibrosis Cystic Fibrosis - blood Cystic Fibrosis - complications Development and progression Diabetes Diabetes Mellitus - blood Diabetes Mellitus - drug therapy Diabetes Mellitus - etiology Drug therapy Drug Therapy, Combination Glucagon-Like Peptide-1 Receptor - agonists Glucagon-Like Peptides - therapeutic use Glycated Hemoglobin A - analysis Humans Hypoglycemic Agents - therapeutic use Insulin - therapeutic use Male Treatment Outcome Young Adult United States diabetes cystic fibrosis semaglutide
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Summary:	Abstract Context and Objective In spite of the evidence that inadequately controlled glycemia is associated with worse clinical outcomes, cystic fibrosis-related diabetes (CFRD) is not well controlled in a majority of patients. The objective of this report is to demonstrate the effect of the addition of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), to basal insulin to control glycemia in one such patient. Design, Intervention, and the Main Outcome Measures The replacement of rapidly acting prandial insulin with semaglutide weekly with continuation of basal insulin. Glycated hemoglobin A1c (HbA1c) was measured and continuous glucose monitoring (CGM) was conducted. Results There was a significant improvement in glycemic control, reduction in HbA1c from 9.1% to 6.7% and stable euglycemic pattern on CGM (mean glucose, 142 mg/dL; SD, 51) within 3 months of starting treatment. There was no increase in plasma pancreatic enzyme concentrations. Conclusions Semaglutide at a low dose was able to replace prandial insulin and control glycemia in combination with basal insulin.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0021-972X 1945-7197
DOI:	10.1210/clinem/dgaa167