PD655 - REDEFINING METABOLIC MANAGEMENT IN CYSTIC FIBROSIS: A CASE REPORT

PD655

REDEFINING METABOLIC MANAGEMENT IN CYSTIC FIBROSIS: A CASE REPORT

V. Zamponi¹, B. Fabrizzi², S. Tedesco¹, N. Campelli¹, M. Taus^1,*

¹UOC Dietetic and Clinical Nutrition, ²Cystic Fibrosis Centre, University Hospital of Marche, Ancona, Italy

Rationale: Nutritional management in people with Cystic Fibrosis (pwCF) has traditionally focused on preventing undernutrition. In the era of highly effective Cystic Fibrosis Transmembrane conductance Regulator (CFTR) modulators, overweight and obesity are emerging challenges, particularly in patients with Cystic Fibrosis–related Diabetes (CFRD), where metabolic control remains complex. Evidence on GLP-1 receptor agonists in pwCF and CFRD is limited.

Methods: We report an 18-year-old female pwCF, genotype F508del/G542X, with pancreatic insufficiency and CFRD on continuous subcutaneous insulin infusion. She had class I obesity, poor metabolic control and family history of metabolic syndrome. Semaglutide (0.5 mg weekly, s.c.) was started. Assessments were performed at baseline (T0) and after one month (T1). Body composition included body weight, Body Mass Index (BMI), Fat Mass (FM), Skeletal Muscle Mass (SMM) and Total Body Water (TBW). Glycemic control was assessed by mean glucose, time in range (70–180 mg/dL) and total daily insulin dose.

Results: From T0 to T1, body weight (83.4–81.6 kg) and BMI (30.6–30.0 kg/m²) decreased. FM declined (29.4–28.1 kg), while SMM (50.6 vs 50.3 kg) and TBW (36.9 vs 36.7 kg) remained stable. Mean glucose improved (247±82 to 182±36 mg/dL) and time in range increased (45% to 66%), with persistent time above range. Insulin dose was unchanged (42 vs 41 U/day). Semaglutide was well tolerated, reducing appetite and energy intake (~200 kcal/day).

Conclusion: Short-term semaglutide was associated with improved body composition and glycemic control without loss of SMM or increased insulin needs. Despite short follow-up, this case suggests GLP-1 receptor agonists may complement insulin therapy, which to date represents the only recommended treatment for CFRD. In this evolving context, their dual effect on glycemic control and weight reduction may support more individualized metabolic management in pwCF.

Disclosure of Interest: None declared