Redefining Cystic Fibrosis-Related Diabetes Management With Tirzepatide: A Case Report

Cystic fibrosis-related diabetes (CFRD) is the most common comorbidity in adults with cystic fibrosis (CF). Traditional management relied on insulin therapy to counter the rise in glucose related to a carbohydrate-rich diet, which was previously recommended. Disease-modifying therapies for CF have, however, changed the metabolic milieu, and we are seeing rising rates of people with CF experiencing weight gain and developing metabolic syndrome. This calls for a paradigm shift in managing CFRD. We describe a 51-year-old woman with long-standing CFRD who, despite basal-bolus insulin, had suboptimal glycaemic control and emerging cardiovascular risk factors. After initiation of tirzepatide, she experienced improved glucose control, HbA1c, weight and blood pressure over three months without major adverse effects. This case illustrates the potential of tirzepatide to address both glycaemic and cardiometabolic risk in CFRD and highlights the need for formal evaluation of GLP-1/GIP receptor agonists in this population.