Canagliflozin improves obesity and insulin resistance in a diabetic patient with Cushings disease undergoing postoperative steroid therapy: A case report

A 47-year-old woman with diabetes treated with high-dose insulin was admitted to Mie University Hospital, Tsu, Japan, for screening of secondary diabetes mellitus and obesity. Laboratory tests and imaging studies were consistent with Cushing's disease (CD). The patient underwent trans-sphenoida...

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Bibliographic Details
Published in:Biomedical reports 2018-12, Vol.9 (6), p.497-502
Main Authors: Nishihama, Kota, Furuta, Noriko, Maki, Kanako, Okano, Yuko, Hashimoto, Rei, Hotta, Yasuhiro, Uemura, Mei, Yasuma, Taro, Suzuki, Toshinari, D'Alessandro-Gabazza, Corina N, Yano, Yutaka, Gabazza, Esteban C
Format: Article
Language:English
Subjects:
Adrenocorticotropic hormone
Blood pressure
Body weight
Canagliflozin
Care and treatment
Case reports
Cushing syndrome
Cushing's disease
Diabetes
Diabetes mellitus
Diabetes therapy
Diabetics
Dosage and administration
Drug therapy
Glucocorticoids
Glucose
Glycosylated hemoglobin
Growth hormones
Health aspects
Health screening
Hemoglobin
Hemoglobins
Hydrocortisone
Hypertension
Hypoglycemic agents
Insulin
Insulin resistance
Laboratories
Laboratory tests
Medical research
Metabolic disorders
Na+/glucose cotransporter
Nervous system diseases
NMR
Nuclear magnetic resonance
Obesity
Patients
Peptides
Pituitary
Proteins
Sodium
Steroid hormones
Surgery
Therapy
Thyroid gland
Tumors
Type 2 diabetes
Universities and colleges
Weight reduction
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Summary:A 47-year-old woman with diabetes treated with high-dose insulin was admitted to Mie University Hospital, Tsu, Japan, for screening of secondary diabetes mellitus and obesity. Laboratory tests and imaging studies were consistent with Cushing's disease (CD). The patient underwent trans-sphenoidal pituitary surgery. The patient exhibited loss of body weight (85.9 to 80.0 kg), improved glycated hemoglobin (HbA1c) (11.2 to 7.8%) and required lower doses of insulin (112 to 46 U/day) 6 months after surgery. The patient's body weight and daily insulin dose remained stable during the following 5 months (6-11 months after surgery). At that point, the patient was administered with canagliflozin, a sodium-glucose cotransporter 2 inhibitor. The patient required lower daily insulin dose without decreasing the dose of postoperative hydrocortisone concurrent to the administration of canagliflozin (100 mg/day). The patient's body weight decreased to 69.5 kg and withdrawal of insulin therapy was possible 8 months after initiation of canagliflozin. Despite withdrawal of insulin therapy, the HbA1c levels remained at
ISSN:2049-9434
2049-9442
DOI:10.3892/br.2018.1153