Long‐term efficacy of the sodium–glucose cotransporter 2 inhibitor, ipragliflozin, in a case of type A insulin resistance syndrome. Issue 5 (20th March 2020)

• Record Type: Journal Article
• Authors: Nagashima, Shuichi; Wakabayashi, Tetsuji; Saito, Naoko; Takahashi, Manabu; Okada, Kenta; Ebihara, Ken; Ishibashi, Shun
• Is Part Of: Journal of diabetes investigation. Volume 11:Issue 5(2020)
• Page Start: 1363
• Page End: 1365
• Publication Date: 2020-03-20
• Subjects: Ipragliflozin -- Sodium–glucose cotransporter 2 inhibitor -- Type A insulin resistance syndrome; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13241
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: Type A insulin resistance (IR) syndrome is a severe IR form caused by insulin receptor ( INSR ) gene defects. Antidiabetic drugs, including high‐dose insulin and insulin‐sensitizing agents, often fail to control associated hyperglycemia. Therapy with recombinant human insulin‐like growth factor 1 can be more effective, but it is expensive. We report a case of type A IR syndrome with an in‐frame INSR heterozygous deletion (ΔLeu999) that was treated with a combination of conventional therapy and ipragliflozin, a sodium–glucose cotransporter 2 inhibitor. Treatment reduced hemoglobin A1c levels (10.0–7.5%) and induced weight loss (54.4–52.0 kg) within 2 months, and the effects were sustained for >3 years. Sodium–glucose cotransporter 2 inhibitors might be useful to normalize blood glucose in type A IR syndrome by reducing bodyweight and ameliorating glucotoxicity. Abstract : This is the first article to report on the long‐term efficacy of ipragliflozin (a sodium–glucose cotransporter 2 inhibitor) in a patient with insulin receptor mutation. Our findings can be helpful in the development of more effective and affordable treatment strategies for patients with severe insulin resistance syndrome.