Semaglutide in Cystic Fibrosis-Related Diabetes

J Clin Endocrinol Metab. 2020 Jul 1;105(7):dgaa167. doi: 10.1210/clinem/dgaa167.

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.

Keywords: cystic fibrosis; diabetes; semaglutide.