Effects of Exenatide in a Morbidly Obese Patient with Type 2 Diabetes

Abstract

IntroductionThe effect of exenatide in weight loss has been reported. Presented here is a case of a morbidly obese patient with type 2 diabetes using exenatide who dramatically lost her body weight in a year and experienced improved glycemic control.Case reportExenatide therapy was initiated for a 59-year-old morbidly obese Japanese woman with type 2 diabetes. To examine the effects of the exenatide treatment, continuous glucose monitoring was performed, and blood was drawn at 0, 30, 60, 120, and 180 min after breakfast to measure insulin, glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP) levels. After 1 year of exenatide therapy, the patient lost 37.5 kg, her glycemic control improved, and her insulin sensitivity recovered. The patient’s levels of insulin, glucagon, active GLP-1, and total GIP also decreased after 1 year of exenatide treatment.ConclusionThe exenatide treatment was effective for reducing body weight and improving glycemic control. After 1 year of exenatide treatment, decreased glucagon, active GLP-1, and total GIP levels were observed following a meal, suggesting that exenatide might affect these hormonal reactions.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-014-0050-6) contains supplementary material, which is available to authorized users.

Pathophysiology‐based phenotyping in type 2 diabetes: A clinical classification tool

“…The hyperbolic function (of normoglycemia) in this area has a tangent vector with a slope close to 45° inferring that the shortest route to normoglycemia will be equal and concomitant improvements in IS and beta cell function. Because hyperinsulinemic type 2 diabetes patients are severely insulin resistant and obese, treatment that improves insulin action seems most logical (Figure C), eg, bariatric surgery or GLP1 agonists …”

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