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Successful treatment of obesity and diabetes with incretin analogue over four years in an adult with Prader–Willi syndrome
Author(s) -
Paisey RB,
Bower L,
Rosindale S,
Lawrence C
Publication year - 2011
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.1621
Subject(s) - medicine , weight loss , diabetes mellitus , insulin , incretin , nausea , blood pressure , vomiting , endocrinology , obesity , exenatide , type 2 diabetes
A 36‐year‐old female diabetic patient with genetically confirmed Prader–Willi syndrome had developed weight increase and severe symptomatic hyperglycaemia despite triple oral hypoglycaemic therapies. Main meals were supervised at home and when working in day care. The addition of insulin therapy induced further weight increase and hypertension with only a small improvement in glycaemia. She suffered from a thrombotic stroke. During rehabilitation her hyperphagia persisted and she was commenced on exenatide in addition to insulin and oral hypoglycaemic agents. Incretin analogue therapy was well tolerated after brief initial nausea. Improved glycaemia allowed insulin to be phased out after six months. General well‐being, weight, blood pressure, microalbuminuria, glycosylated haemoglobin, and serum lipids all showed sustained improvement. Despite concerns about hyperphagia and resultant severe vomiting in Prader–Willi syndrome, our patient responded safely to incretin analogue therapy. Weight loss and metabolic improvements have been sustained for four years. Copyright © 2011 John Wiley & Sons.