Endocrine Abstracts

Introduction: Childhood obesity continues to prove a major public health concern, with obesity and metabolic syndrome becoming increasingly prevalent in children and young people with type 1 diabetes mellitus (T1DM). Glucagon-like peptide 1 (GLP-1) therapy has shown promising results for weight loss in adults with type 2 diabetes mellitus (T2DM) and has recently been licensed for the treatment of adolescents living with obesity. Liraglutide has been shown to be beneficial in few adult studies by improving glycaemic control and promoting weight loss in patients with T1DM as an adjunct to insulin therapy. There is no such data available for children or adolescents with T1DM. We report the use of Liraglutide in an adolescent with T1DM and significant obesity.

Case Report: A 16-year-old female with T1DM, coeliac disease, fatty liver, and dyslipidaemia was noted to be gaining weight rapidly after the diagnosis of T1DM at the age of 14 years. She was managed with insulin therapy and continuous glucose monitoring (CGM). Weight upon diagnosis was 76.6 kg (+2.31SDS). Since diagnosis, the weight continued to escalate rapidly [40.4 kg weight gain in a 12-month period]. Challenges in diet management, altered sleep pattern and lack of physical activity contributed to the weight gain. Despite attempts at lifestyle modification and intense input from MDT, the weight rose to 122.8 kg (+6.83 SDS) with a BMI of 43.8 kg/m² (+3.70 SDS). Hence, Liraglutide was commenced at a dose of 0.6 mg once daily and increased to a maximum dose of 3 mg over a 6-week period with close monitoring of blood glucose. Following this, the weight escalation slowed down and the latest BMI has dropped slightly to 43.0 kg/m² (+3.64 SDS). No change in glycaemic control has been noted and there were no side effects.

Conclusion: GLP-1 therapy has the potential to support weight loss in adolescent patients with T1DM and obesity. However, long term data is necessary to assess the safety and efficacy. Further studies would help to establish the long-term benefits of GLP1 analogues (in terms of glycaemic control and weight loss) in adolescents with T1DM.