The GLP-1 receptor agonist exenatide may be a better alternative to insulin for the management of cystic fibrosis-related diabetes (CFRD), a pilot study carried out by respiratory physicians and endocrinologists in South Australia suggests.
In a study involving six young people with CF, pancreatic exocrine insufficiency and impaired glucose tolerance (IGT), they found that a subcutaneous injection of exenatide (2.5mg) prevented the postprandial hyperglycaemic response.
Exenatide appeared to exert its effect on postprandial hyperglycaemia by slowing gastric emptying time, according to Dr Myfanwy Geyer and colleagues at the Women’s and Children’s Hospital and the University of Adelaide.
When they assessed the impact of exenatide compared to placebo in a crossover study of two doses, the postprandial AUC240 for blood glucose was reduced from 1814 to 1431 mmol/L and the peak glucose level was reduced from 9.53 to 7.65 mmol/L.
Insulin, C-peptide, and incretin concentrations were significantly reduced after exenatide compared to placebo, whereas glucagon levels did not differ.
Gastric emptying was markedly slower after exenatide compared to placebo according to measures of 10% gastric emptying (139 vs 55 minutes).