Sana Hasan, Cleveland Clinic, United States of America
Title : The effect of CFTR modulators on the progression of cystic fibrosis related diabetes
Cystic fibrosis-related diabetes (CFRD) is the most common endocrine complication of CF. 40–50% of CF patients have CFRD in adulthood. As survival improves with cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy, the proportion of CF adults with CFRD may exceed the current 40–50% estimate.
We investigated the effect of CFTR modulators on the progression of CFRD. Patients with a diagnosis of CFRD, who were prescribed one of the three CFTR modulators (Ivacaftor, Tezacaftor /Ivacaftor and Ivacaftor/Lumacaftor) were included in the study. Average patient age was 28.7 ± 6.3 years. Mean treatment duration with CFTR modulators was 27.2 ± 12.9 months. We compared the changes in A1c, body weight and FEV1% predicted pre and post treatment. A1c reduced significantly after CFTR modulators treatment and difference was statistically significant (6.4 ± 1.09 pretreatment vs 5.9 ± 0.68 post treatment, ? -0.49 ± 1.05, P = 0.031). Significant improvement were also observed in weight (kg) after treatment with CFTR modulators (55.7 ± 9.6 pretreatment vs 57.9 ± 10.5 post treatment, ? 2.2 ± 5.2, P = 0.049). FEV1 % predicted increased significantly after treatment (46.8 ± 24.4 pretreatment vs 55.8 ± 28.2 post treatment, ? 9.0 ± 14.1, P = 0.004). To date, this is the first research study with the longest treatment duration that shows that CFTR modulators have a positive effect on improving CFRD.
This presentation will focus on the mechanisms involved in the pathogenesis of CFRD, the role of CFTR in the regulation of insulin secretion and the effect of CFTR modulators on glucose tolerance, insulin secretion and progression of CFRD.
Dr. Hasan received her medical degree from Ohio University Heritage College of Osteopathic Medicine in 2008. She continued her post graduate training at Akron City Hospital in Internal Medicine. Her interest in research and endocrinology enabled her to pursue a three-year research fellowship in Endocrinology and Metabolism at University of Nebraska Medical Center in Omaha, NE. Her research on the effects of All-trans Retinoic acid in obesity related type 2 diabetes was well recognized, leading to poster presentations at the 95th annual Endocrine Society meeting in 2013, 2014 and 2105 as well as 74th American Diabetes Association meeting in 2014. Her academic achievements throughout fellowship led to her appointment as a Clinical Instructor at University of Nebraska Medical Center in 2014. She was honored to present her work on All-trans Retinoic acid on weight, glucose homeostasis and white adipose tissue internationally, initially at 22nd European Congress on Obesity in Prague in 2015, followed by the European Association for the Study of Diabetes 51st Annual meeting in Stockholm, later that year. Dr. Hasan’s strong academic and research background led to her appointment as a Staff for the Endocrinology and Metabolism Institute in 2015. She assumed the role of the Director of Endocrinology, South Region in 2019. She was subsequently awarded an EnVision grant for her role as a primary investigator in her study of optimizing glycemic control in Cystic fibrosis related diabetes.