Prediabetes is a frequently occurring condition with increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established antidiabetic agents, also used to treat obesity. There is limited, yet promising evidence on their use in prediabetes. T2DM was less frequent among subjects on liraglutide, semaglutide and tirzepatide compared with the control arm. Delayed progression to T2DM has also been observed. Furthermore, normoglycaemia was achieved for subjects on liraglutide (up to 66
Background and Objectives: Persistent pain in rheumatoid arthritis (RA) may reflect mechanisms not fully captured by systemic inflammatory markers. This study estimated the frequency of elevated Central Sensitization Inventory (CSI) scores in women with RA and examined associations with pain, fatigue, depressive symptoms, function, inflammatory markers, and disease activity. Materials and Methods: This prospective single-center observational cohort included 97 female inpatients who completed a standardized three-week rehabilitation program. The CSI was used as a symptom-based screening instrument. Pain, function, fatigue, and depressive symptoms were assessed with the Visual Analog Scale (VAS), Health Assessment Questionnaire (HAQ), FACIT-Fatigue scale, and Beck Depression Inventory-II (BDI-II), respectively. Results: Fifty-seven participants (58.8%) had CSI scores ≥ 40. Higher CSI scores were associated with greater pain, more depressive symptoms, more fatigue, and higher DAS28-CRP scores, but not with ESR, CRP, IL-6, or disease duration. In adjusted baseline models, the association with VAS pain was statistically significant but modest (unstandardized beta = 0.024 per CSI point; standardized beta = 0.273). Across the three-week follow-up, VAS pain decreased by 2.53 points; mean FACIT-Fatigue and HAQ changes were smaller than commonly cited clinically important thresholds, and CSI changed only modestly. In adjusted multivariable models, higher CSI scores remained independently associated with VAS pain, FACIT-Fatigue, and BDI-II scores, whereas no significant association was found with HAQ. CSI was not associated with CRP, IL-6, or disease duration. Conclusions: In this cohort of women with RA, elevated CSI scores identified a greater self-reported symptom burden and were independently associated with pain, fatigue, and depressive symptoms after adjustment, though the pain association remained modest in magnitude. No meaningful association was found with functional disability. The uncontrolled, single-arm design and restricted inflammatory-marker range preclude causal conclusions or proof that symptoms were independent of inflammation.
Cystic fibrosis (CF) is a monogenic disorder leading to pulmonary disease, pancreatic insufficiency and cystic fibrosis-related diabetes (CFRD). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are now being investigated in people with cystic fibrosis (pwCF) and CFRD. To date, their therapeutic potential has been almost exclusively studied in case reports or case series. These agents improved glycated haemoglobin (HbA1c) and continuous glucose monitoring (CGM) parameters. Benefits were also observed in weight reduction, particularly for subjects on cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy elexacaftor/tezacaftor/ivacaftor (ETI). However, discordant results have also been reported. Moreover, GLP-1RAs have improved pulmonary function, even following lung transplantation. Importantly, the dual glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist tirzepatide has also yielded favourable outcomes. Finally, preliminary evidence suggests potential inhibition of bone resorption, pointing to a therapeutic perspective in cystic fibrosis-related bone disease (CFBD). However, potential adverse events should not be ignored. These include risk of acute pancreatitis, nausea/vomiting, nutritional depletion, bowel dysmotility and distal intestinal obstruction syndrome, as well as others. Adverse events should be addressed with caution, and dose adjustments may be useful. Large prospective multicentre studies are now required to validate these outcomes and to suggest implications for clinical practice.
BACKGROUND:Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized treatment for type 2 diabetes mellitus (T2DM), obesity and beyond. Current research focuses on the use of the dual agonist of glucagon-like peptide-1 receptor (GLP-1R) and glucose-dependent insulinotropic polypeptide receptor (GIPR), tirzepatide. AREAS COVERED:This narrative review focuses on the clinical potential of tirzepatide in type 1 diabetes mellitus (T1DM). A literature search in PubMed/MEDLINE, Scopus and Google Scholar until March 2026 was conducted using appropriate keywords. Glycated hemoglobin (HbA1c) was reduced by up to 0.9% and body weight by up to 23.4% corresponding to a reduction in body-mass index by up to 9.0 kg/m2. Continuous glucose monitoring (CGM) has shown that time in range (TIR) increased by up to 18.0%, almost exclusively due to reduced time above range (TAR). Daily insulin requirements were reduced by up to 38 units/day. EXPERT OPINION:Tirzepatide was associated with optimized glycemic control and reduced insulin requirements. These benefits were partly, but not exclusively, mediated by weight loss. Currently available studies are largely observational and have included subjects with overweight or obesity. Future randomized controlled trials are now required to further corroborate these promising findings.
