Hypoglycaemia after Initiation of CFTR Modulator Therapy in a Cystic Fibrosis Patient without Diabetes

Introduction. Cystic fibrosis transmembrane regulator (CFTR) modulator therapies improve respiratory function and glycaemic control in patients with cystic fibrosis (CF). The direct effect of CFTR modulator therapies on pancreatic function in patients without preexisting diabetes remains unclear. Ca...

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Bibliographic Details
Published in:Case reports in endocrinology 2023-12, Vol.2023, p.9769119-4
Main Authors: Yskout, Marie, Vliebergh, Joke, Bor, Hakan, Dupont, Lieven, Lorent, Natalie, Van Bleyenbergh, Pascal, Gillard, Pieter, Van der Schueren, Bart, Mertens, Ann, Mathieu, Chantal, Vangoitsenhoven, Roman
Format: Article
Language:English
Subjects:
Carbohydrates
Care and treatment
Case reports
Cystic fibrosis
Dextrose
Diabetes
Diabetes therapy
Genetic aspects
Glucose
Homeostasis
Hypoglycemia
Insulin
Insulin resistance
Ivacaftor
Pathophysiology
Patients
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Summary:Introduction. Cystic fibrosis transmembrane regulator (CFTR) modulator therapies improve respiratory function and glycaemic control in patients with cystic fibrosis (CF). The direct effect of CFTR modulator therapies on pancreatic function in patients without preexisting diabetes remains unclear. Case Presentation. An 18-year-old female with CF caused by F508del/F508del mutation, who had no diabetes, developed postprandial hypoglycaemias 6 months after initiation of elexacaftor, tezacaftor, and ivacaftor combination therapy (ETI). Symptoms were persisted after brief discontinuation of ETI, but her symptoms and time-in-hypoglycaemia had improved remarkably by avoiding high glycaemic index-foods. Discussion. This case of hypoglycaemia associated with CFTR modulator therapy in a patient without preexisting diabetes suggests that CFTR modulator therapy has the potential to directly affect glucose homeostasis. There might be an improvement in insulin secretion as well as a reduction in systemic insulin resistance. Conclusion. Treatment of CF patients without diabetes with CFTR modulator therapies can cause recurrent hypoglycaemic episodes which resolve with dietary measures.
ISSN:2090-6501
2090-651X
DOI:10.1155/2023/9769119