Endocrine Abstracts

Patient C., b. 1962 went to the clinic to a urologist with complaints of painful, rapid urination, dry mouth, thirst, a constant feeling of hunger in the daytime. A biochemical blood glucose(bg) level of 10.4 on an empty stomach. At the initial examination by an endocrinologist, bg at a reception of –8.0 mM/l on an empty stomach. BP-134/78 Ps-78. Height-178 Weight-101.5 BMI-32.0. HbA1c-7.4% basal insulin(bi)-28.3 (3.0–25.0) stimulated insulin(si)-56 (3.0–25.0). Basal C-peptide-4.8 (0.8–5.1). Stimulated C-peptide-7.1 (0.8–5.1). Leptin-28.0 (3.7–11.3). The diagnosis was made: T2DM with a target level of HbA1c of less than 6.5%.

Background: Obesity 1 Recommended: Dapagliflozin 10 mg Sibutramine 10 mg. After 21 days bg intake 6.4 2 hours after breakfast. GP: 5.1–4.5-5.4–5.8. Weight-93.5 (–2.5 per week) and –8.0 for the entire observation period – 3 weeks. After 30 days bi 8.3 (3.0–25.0), si 16 (3.0–25.0). Basal C-peptide-1.8 (0.8–5.1). Stimulated C-peptide-2.1(0.8–5.1) Leptin-8.0(3.7–11.3) bg at the reception is 5.5 mM/l 2 hours after breakfast. GP: 5.3–5.9–6.6–5.5 mM/l. Weight-90.0 (–11.5) per month –3.5 kg per 1 week. After 2.5 months from the start of therapy: bg at the reception – 4.3 on an empty stomach. GP: 4.1–5.2–5.3–6.1. BP-115/78 Pulse-78. Weight 79 (–11.0 per month and –22.5 for 2 months) bi-5.3 (3.0–25.0) si-7.2 (3.0–25.0). Basal C-peptide-1.1 (0.8–5.1). C-peptide stimulated-1.6 (0.8–5.1). Leptin-5.3 (3.7–11.3). HbA1c-5.7%. Patient canceled dapagliflozin 10 and sibutramine 10. Prescribed sitagliptin 100 daily morning. After 3.5 months from the start of therapy admission bg – 5.4 2 hours after breakfast. Weight-79.5 (+ 0.5) Height-178 BMI-25.09. GP: 4.9–4.6–5.5–4.8. Continued taking sitagliptin 100 mg in the morning. After 6 months from the last dose and 9.5 months from the start of therapy. BG 5.3 mM/l 2 hours after breakfast. GP 5.1–5.4–5.7–6.1 mM/l during the day. Weight 79.0 (-0.5 for 6 months) Height-178 BMI-25.01 Insulin-4.5 Leptin-1.2 C-peptide-0.9 HbA1c-5.4% BP-121/77, pulse-78 without taking antihypertensive therapy.

Conclusion: The potentiation of the effect of dapagliflozin and sibutramine at the start of treatment of T2DM contributes to the formation of proper eating behavior, a decrease in the calorie content of the daily diet and, thus, leads to the compensation of carbohydrate metabolism in a shorter time, as a result of compliance with the principle of compliance and influence on the pathophysiological mechanisms of the disease