Stopping Diabetes Before It Starts: Dr. Adèle Coriati’s Vision for Healthier Lives with Cystic Fibrosis

Throughout her early career Dr. Adèle Coriati has been trying to answer an important question with real implications for people living with cystic fibrosis (CF): which people with CF develop diabetes, and can we prevent it before it begins? 

She first explored this question during her PhD in clinical nutrition at the Université de Montréal. Today, as a professor in the Department of Nutrition at the University of Montreal and researcher at the Santé Québec Nord-de-l’Île-de-Montréal-Universitaire, that same question remains at the centre of her work.  

The urgency is clear. Cystic fibrosis–related diabetes (CFRD) is the most common complication of cystic fibrosis, affecting nearly half of all adults living with the disease. As people within the CF population live longer and rates of obesity rise, the burden of CFRD is expected to grow. Emerging evidence also suggests that its clinical presentation may increasingly resemble type 2 diabetes, with insulin resistance playing a larger role. 

For Dr. Coriati however, the challenge isn’t just about how many people develop diabetes. It’s about what follows. 

“Diabetes will increase your risk of developing other complications,” she explains. Conditions like obesity, high blood pressure, high cholesterol, and insulin resistance can compound over time.  

Her goal is to stop what she describes as a “vicious cycle” before it begins. 

Looking for early warning signs in the body 

With support from a Seed Grant from Cystic Fibrosis Canada in partnership with Diabetes Canada, Dr. Coriati is searching for ways to detect risk years earlier than current tools allow. 

Instead of focusing only on blood sugar levels, her team is using lipid-omics, a method that analyzes tiny fat molecules called lipids in the blood, to uncover subtle changes linked to diabetes.  

Using blood samples from over 120 people with CF, along with 40 people without CF, her team is looking for patterns linked to the development of CFRD.  

“We are trying to develop a signature that will help us to predict who is at risk of developing diabetes,” she explains. 

Dr. Coriati and her team are in the final stages of determining which lipids and at what levels can be used as biomarkers of early signs of diabetes. 

Her goal is that one day, these patterns could help clinicians identify high-risk patients earlier and intervene before diabetes develops. 

“If a patient comes into clinic with this specific profile,” she explains, “we can implement nutritional or physical activity interventions to prevent the development of diabetes.” 

A different kind of diabetes 

“What we see is different than what is known in type 2 diabetes,” Dr. Coriati says.  

Her findings suggest that CF-related diabetes (CFRD) is a distinct form of diabetes, driven by molecular mechanisms that differ fundamentally from those involved in type 1 and type 2 diabetes. 

This finding points to why CF-specific research is essential. Approaches based on the general population may not fully apply, and without targeted research, important signals could be missed. 

Her study captures an important moment in CF care. The samples were collected before CFTR modulators became widely available, offering a clearer picture of how metabolism works in CF without these treatments.  

As she continues to complete this study, she is also working toward the next step: expanding this research to include people on modulators and scaling it into larger, multi-centre studies across Canada. 

“The bigger the population, the more convincing it is,” she says. 

Research shaped by the CF community 

At the heart of Dr. Coriati’s work is a strong commitment to patient partnership. 

She regularly seeks input from people with CF and their families to help guide research priorities and study design. 

“I want patient feedback,” she says. “I want to see if this is important for them, if what I'm doing is important.” 

While her current research focuses on adults, community input has highlighted the need to study children and adolescents, where changes may begin long before symptoms appear. 

“The smart way is to look at kids and see if we can do something even before they become adults,” she explains. 

She is also mindful that not everyone benefits equally from recent advances in care. 

“There’s also a small proportion of the CF population that cannot access, or is not eligible for modulators,” she says. “So, we still have to keep going.”  

Ultimately, her work is about identifying risk sooner, starting care earlier, and giving people with CF the chance to prevent diabetes and its related cardiometabolic complications before it begins.