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

Abstract

for screening of secondary diabetes mellitus and obesity. Laboratory tests and imaging studies were consistent with Cushing's disease (CD). The patient underwent transsphenoidal 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 sodiumglucose 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 <7.0%. Although surgical treatment is the first-choice treatment for CD, obesity-related metabolic disorders including diabetes are frequent in CD patients following surgery. Canagliflozin may be an effective treatment to reduce body weight and improve insulin resistance following surgical treatment of CD.

Effects of tofogliflozin on adrenocorticotropic hormone, renin and aldosterone, and cortisol levels in elderly patients with diabetes mellitus

“…[ 21 ] Moreover, canagliflozin was found to improve obesity and insulin resistance in a diabetic patient with Cushing disease undergoing postoperative steroid therapy. [ 22 ]…”

“…A case study has been shown that ACTH and cortisol levels were inadequately increased in patients with T2DM [21] . Moreover, canagliflozin was found to improve obesity and insulin resistance in a diabetic patient with Cushing disease undergoing postoperative steroid therapy [22] …”

“…[21] Moreover, canagliflozin was found to improve obesity and insulin resistance in a diabetic patient with Cushing disease undergoing postoperative steroid therapy. [22] Furthermore, cortisol serves, in part, as a mineralocorticoid despite its drawback.…”