Top

Journal of Medical Case Reports

Published in:

Open Access 01-12-2014 | Case report

Effective weight loss after treatment with a glucagon-like peptide-1 receptor agonist in a morbidly obese and diabetic patient before bariatric surgery: a case report

Authors: Jui-Hung Chen, Wen-Hao Tang, Chien-Hsing Lee

Published in: Journal of Medical Case Reports | Issue 1/2014

Abstract

Introduction

Glucagon-like peptide-1 receptor agonists, a new class of anti-diabetic drugs, are widely used in the treatment of type 2 diabetes. However, the effect of glucagon-like peptide-1 receptor agonists on the treatment of preoperative weight loss in obese type 2 diabetic patients has not been reported.

Case presentation

A 38-year-old Taiwanese woman presented to our hospital with morbid obesity and type 2 diabetes mellitus. Bariatric surgery was recommended by a general surgery specialist. Weight loss before surgery was recommended to reduce the frequency of surgical complications. In addition to diet control with lifestyle modifications, pharmacological treatment with metformin and glucagon-like peptide-1 receptor agonists was administered. Fourteen months of treatment reduced her hemoglobin A1c level from 7.4 to 5.5% and reduced her body weight by 21.2kg.

Conclusions

One year of diet control with lifestyle modifications and pharmacological treatment with glucagon-like peptide-1 receptor agonists and metformin markedly decreased hemoglobin A1c levels and resulted in effective and substantial weight loss in a morbidly obese patient with dysregulated diabetes during the preoperative period.

Available only for authorised users

Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, Bantle JP, Sledge I: Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009, 122: 248-256. 10.1016/j.amjmed.2008.09.041. e5CrossRefPubMed

Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, Eid GM, Mattar S, Ramanathan R, Barinas-Mitchel E, Rao RH, Kuller L, Kelley D: Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003, 238: 467-484. discussion 84–5PubMedPubMedCentral

Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjostrom CD, Sullivan M, Wedel H, Swedish Obese Subjects Study Scientific, Group: Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004, 351: 2683-2693. 10.1056/NEJMoa035622.CrossRefPubMed

Benotti PN, Still CD, Wood GC, Akmal Y, King H, El Arousy H, Dancea H, Gerhard GS, Petrick A, Strodel W: Preoperative weight loss before bariatric surgery. Arch Surg-Chicago. 2009, 144: 1150-1155. 10.1001/archsurg.2009.209.CrossRefPubMedPubMedCentral

Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, Ko CY, Gibbons MM: Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009, 5: 713-721. 10.1016/j.soard.2009.08.014.CrossRefPubMed

Vargas MA, Fernandez NC, Serrano JO: Preoperative weight loss in patients with indication of bariatric surgery: which is the best method?. Nutr Hosp. 2011, 26: 1227-1230.

Nauck MA, Wollschlager D, Werner J, Holst JJ, Orskov C, Creutzfeldt W, Willms B: Effects of subcutaneous glucagon-like peptide 1 (GLP-1 [7–36 amide]) in patients with NIDDM. Diabetologia. 1996, 39: 1546-1553. 10.1007/s001250050613.CrossRefPubMed

Larsson H, Holst JJ, Ahren B: Glucagon-like peptide-1 reduces hepatic glucose production indirectly through insulin and glucagon in humans. Acta Physiol Scand. 1997, 160: 413-422. 10.1046/j.1365-201X.1997.00161.x.CrossRefPubMed

Assoc AD: Standards of medical care in diabetes-2013. Diabetes Care. 2013, 36: S11-S66.CrossRef

10.

Adams JP, Murphy PG: Obesity in anaesthesia and intensive care. Brit J Anaesth. 2000, 85: 91-108. 10.1093/bja/85.1.91.CrossRefPubMed

11.

VanGaal LF, Wauters MA, DeLeeuw IH: The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obesity. 1997, 21: S5-S9.

12.

Busetto L, Tregnaghi A, De Marchi F: Liver volume and visceral obesity in women with hepatic steatosis undergoing gastric banding. Obes Res. 2002, 10: 408-411. 10.1038/oby.2002.56.CrossRefPubMed

13.

Shyangdan DS, Royle P, Clar C, Sharma P, Waugh N, Snaith A: Glucagon-like peptide analogues for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2011, CD006423-

14.

Buse JB, Klonoff DC, Nielsen LL, Guan XS, Bowlus CL, Holcombe JH, Maggs DG, Wintle ME: Metabolic effects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: an interim analysis of data from the open-label, uncontrolled extension of three double-blind, placebo-controlled trials. Clin Ther. 2007, 29: 139-153. 10.1016/j.clinthera.2007.01.015.CrossRefPubMed

15.

Ratner RE, Maggs D, Nielsen LL, Stonehouse AH, Poon T, Zhang B, Bicsak TA, Brodows RG, Kim DD: Long-term effects of exenatide therapy over 82 weeks on glycemic control and weight in over-weight metformin-treated patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2006, 8: 419-428. 10.1111/j.1463-1326.2006.00589.x.CrossRefPubMed

Title: Effective weight loss after treatment with a glucagon-like peptide-1 receptor agonist in a morbidly obese and diabetic patient before bariatric surgery: a case report
Authors: Jui-Hung Chen
Wen-Hao Tang
Chien-Hsing Lee
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2014
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-8-304

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effective weight loss after treatment with a glucagon-like peptide-1 receptor agonist in a morbidly obese and diabetic patient before bariatric surgery: a case report

Abstract

Introduction

Case presentation

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2014

Right hepatectomy due to portal vein thrombosis in vasculobiliary injury following laparoscopic cholecystectomy: a case report

Glycosuria medicated with ipragliflozin and nifedipine or ipragliflozin and candesartan: a case report

The intricate relationship of histoplasmosis and sarcoidosis: a case report

Radical excision combined with instrumented fixation in the management of thoracic epidural angiolipoma: a case report

A de novo monoclonal immunoglobulin deposition disease in a kidney transplant recipient: a case report

Computed tomography-guided resection of osteoid osteoma of the sacrum: a case report