Endocrinology Department, University Hospital La Paz, Madrid, Spain; Escuela de Doctorado, Universidad Autónoma de Madrid, Spain.
Endocrinology Department, University Hospital La Paz, Madrid, Spain.
Diabetes Res Clin Pract. 2024 Oct;216:111839. doi: 10.1016/j.diabres.2024.111839. Epub 2024 Aug 24.
To evaluate the impact of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on Cystic Fibrosis Related Diabetes (CFRD) glycemic control and insulin treatment in patients with CFRD during clinical practice.
We carried out a retrospective observational study of 23 adult patients with CFRD who started treatment with ETI. They had, at least, one F508del mutation. Data were collected before ETI initiation and 3, 6, and 12 months after.
Glycemic control measured by HbA1c significantly improved by 0.3 % (0.1-0.5) after 3 months of ETI therapy (p = 0.004) and kept this improvement during follow-up (p < 0.001). The proportion of patients needing multiple daily injections of insulin was reduced by 16 % (p = 0.023). Total daily insulin dose dropped by 0.12 (0.05-0.18) UI/kg/day (p < 0.001). Data derived from Flash Continuous Glucose Monitoring (CGM) for patients treated with insulin stayed unchanged after insulin reduction, except for a significant 8 % (0.3-15.6) increase in the Time In Tight Range (TITR) between 70 and 140 mg/dL (p = 0.043).
ETI therapy impacted CFRD in clinical practice reducing insulin needs and improving glycemic control measured by HbA1c and CGM. The improvements can be observed from the first 3 months of treatment.
评估依利卓（elexacaftor/tezacaftor/ivacaftor，ETI）疗法对囊性纤维化相关性糖尿病（Cystic Fibrosis Related Diabetes，CFRD）患者的血糖控制和胰岛素治疗的影响。
我们对 23 名开始接受 ETI 治疗的 CFRD 成年患者进行了回顾性观察研究。这些患者至少携带一个 F508del 突变。在开始 ETI 治疗前和治疗后 3、6 和 12 个月收集数据。
治疗 3 个月后，HbA1c 测量的血糖控制显著改善了 0.3%（0.1-0.5）（p=0.004），并在随访期间保持了这种改善（p<0.001）。需要每日多次注射胰岛素的患者比例降低了 16%（p=0.023）。每日胰岛素总剂量减少了 0.12（0.05-0.18）UI/kg/天（p<0.001）。接受胰岛素治疗的患者的 Flash 连续血糖监测（CGM）数据在胰岛素减少后保持不变，除了 70-140mg/dL 之间的 TITR（Time In Tight Range）显著增加了 8%（0.3-15.6）（p=0.043）。
ETI 治疗在临床实践中对 CFRD 有影响，降低了胰岛素的需求，改善了 HbA1c 和 CGM 测量的血糖控制。这些改善可以在治疗的前 3 个月观察到。
