Switching from Insulin to Liraglutide Improved Glycemic Control and the Quality of Life Scores in a Case of Type 2 Diabetes and Active Crohn's Disease

Abstract

A 44-year-old man with type 2 diabetes of five years' duration was admitted for the management of poor glycemic control despite the administration of insulin therapy. On admission, he received vigorous treatment for a 28-year history of Crohn's disease and a 14-year history of a psychiatric disorder. His glycosylated hemoglobin A1c (HbA1c) level was 11.3%, his fasting blood glucose level was 567 mg/dL and his C-peptide level was 1.0 ng/mL. His quality of life (QOL) was severely impaired as a result of frequent episodes of hyperglycemia and hypoglycemia. Treatment with liraglutide was commenced in place of insulin, which improved the patient's glycemic control to an HbA1c level of 5.5% and markedly increased his QOL score with no hypoglycemia.

European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint ESPEN/UEG guideline

“…Initial experimental data in animals suggest that Glucagon-like Peptide 1 (GLP-1) receptor agonists may positively affect homeostasis and immune activity in the gut [102,103] and modulate altered visceral sensation in IBS [104]. One case report on the use of liraglutide in a patient with CD has been published [105]. No safety concerns have been raised.…”

European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline

“… 104 One case report on the use of liraglutide in a patient with CD has been published. 105 No safety concerns have been raised. Naltrexone/Bupropion.…”

“…Initial experimental data in animals suggest that Glucagon‐like Peptide 1 (GLP‐1) receptor agonists may positively affect homeostasis and immune activity in the gut 102,103 and modulate altered visceral sensation in IBS 104 . One case report on the use of liraglutide in a patient with CD has been published 105 . No safety concerns have been raised. Naltrexone/Bupropion.…”

“…Successively this index was investigated in a retrospective study of biopsy-proven diagnosis in 324 subjects with clinical and/or ultrasonography suspicion of NAFLD. The study population was characterized by a median BMI (kg/m 2 ) of 29(26)(27)(28)(29)(30)(31)(32)(33), median waist circumference (cm) of 101(92)(93)(94)(95)(96)(97)(98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109), and a high prevalence of type 2 diabetes (41%). The marker displayed an acceptable accuracy in estimating the presence of steatosis of any amount versus no steatosis; AUROCs of 0.80 (0.69-0.88).…”

Bélbetegségek diabetes mellitusban

“…41 Japán esetbemutatásban Crohn-betegségben szenvedő cukorbetegben kedvező hatást értek el, amint az inzulint liraglutidra cserélték: a vércukor-és a HbA 1c -érték csökkent, a beteg életminősége javult. 42 Az inzulinkezelés IBD lefolyására gyakorol hatása nem ismert. Az IGF-1 rendszer gyulladást gátló hatású kísérletes colitismodelleken.…”