Endocrine Abstracts

Introduction: Liraglutide is a glucagon-like peptide 1 (GLP-1) receptor agonist, approved for the treatment of adult patients with type 2 diabetes mellitus of a particular interest in the significant improvement of glycaemic, systolic blood pressure and lipid control with their impact on weight, making it possible to avoid this infernal spiral of weight gain-increased insulin resistance.

Observation: 55-year-old female patient, known diabetic for 10 years, put on metformin 2 g.

Before liraglutide: the patient had grade 2 obesity (Weight = 102 kg, BMI = 37.5 kg/m²). HbA1c = 8.4%, Total cholesterol = 2 g/l, LDL = 1.4 g/l, HDL = 0,36 g/l. After 18 months of liraglutide 1.8 mg/j and metformin 2 g : weight loss of 20 kg (weight= 82 kg, BMI = 29 kg/m²). HbA1c = 6.5%, Total cholesterol = 1,5 g/l, LDL = 0.8 g/l, HDL = 0,42 g/l

Discussion: Incretins are digestive tract hormones secreted in response to oral carbohydrate intake. They stimulate the secretion of insulin, inhibit that of glucagon, slow down gastric emptying and increase satiety, thus allowing weight loss. These molecules have pleiotropic effects enriching current therapy, with associated weight loss, allowing better control of diabetes. We report in this case a significant weight loss with an improvement of glycaemic and lipid control without any episode of hypoglycemia.

Conclusion: At a time of epidemics of chronic diseases such as obesity associated with type 2 diabetes, recent therapeutic options focusing on several targets are emerging, such as GLP-1 analogues.

References: Forte Marques, & all. (2015). Analogues du GLP-1 vs inhibiteurs du SGLT-2 pour les diabétiques de type 2 obèses. Revue Médicale Suisse, 11(477), 1227–1233.

Halimi, S. (2013). Prise en charge du diabète de type 2. Presse Médicale, 42(5), 861–870.