Semaglutide in Cystic Fibrosis-Related Diabetes
Helen Prathiba Gnanapragasam, Naghma Mustafa, Mary Bierbrauer, Tara Andrea Providence, Paresh Dandona
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.