Editorial
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2020; 11(6): 213-217
Published online Jun 15, 2020. doi: 10.4239/wjd.v11.i6.213
Cystic fibrosis-related diabetes: The unmet need
Leonardo Pozo, Fatimah Bello, Yamely Mendez, Salim Surani
Leonardo Pozo, Fatimah Bello, Internal Medicine, University of Texas Rio Grande Valley, Edinburg, TX 78539, United States
Yamely Mendez, Research Department, Baylor College of Medicine, Houston, Texas. 77030, United States
Salim Surani, Medical Critical Care Services, Corpus Christi Medical Center, Corpus Christi, TX 78404, United States
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Salim Surani, BSc, FACC, FACP, FCCP, MD, Professor, Medical Critical Care Services, Corpus Christi Medical Center, 701 Ayers street, Corpus Christi, TX 78413, United States. srsurani@hotmail.com
Received: February 9, 2020
Peer-review started: February 9, 2020
First decision: April 3, 2020
Revised: April 14, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: June 15, 2020
Processing time: 114 Days and 6.6 Hours
Abstract

Cystic fibrosis (CF) is a common autosomal recessive disease. Life expectancy of patients with CF continues to improve mainly driven by the evolving therapies for CF-related organ dysfunction. The prevalence of CF-related diabetes (CFRD) increases exponentially as patients’ age. Clinical care guidelines for CFRD from 2010, recommend insulin as the mainstay of treatment. Many patients with CFRD may not require exogenous insulin due to the heterogeneity of this clinical entity. Maintenance of euglycemia by enhancing endogenous insulin production, secretion and degradation with novel pharmacological therapies like glucagon-like peptide-1 agonist is an option that remains to be fully explored. As such, the scope of this article will focus on our perspective of glucagon-like peptide-1 receptor agonist in the context of CFRD. Other potential options such as sodium-glucose cotransporter-2 and dipeptidyl peptidase 4 inhibitors and their impact on this patient population is limited and further studies are required.

Keywords: Cystic fibrosis; Cystic fibrosis-related diabetes; Cystic fibrosis transmembrane conductance regulator; Gastric inhibitory polypeptide; Glucagon-like peptide 1; Glucagon-like peptide-1 receptor agonist; Dipeptidyl peptidase 4 inhibitors

Core tip: Cystic fibrosis-related diabetes is a heterogeneous entity. Currently, insulin is the agent of choice to maintain euglycemia on this patient population. Novel therapies like glucagon-like peptide-1 agonist offer an opportunity to reevaluate the way we approach this disease.