Sodium –glucose cotransporter 2 inhibitor and sarcopenia in a lean elderly adult with type 2 diabetes: A case report

We report a case in which the sodium –glucose cotransporter 2 inhibitor, dapagliflozin, contributed to the development of ketosis and sarcopenia in a lean elderly woman with type 2 diabetes. Sodium–glucose cotransporter 2 inhibitor use and reduced β‐cell function together resulted in insulinopenia and probably hyperglucagonem ia, which enhanced proteinolysis and impaired protein synthesis in the muscle, thereby leading to the patient developing sarcopenia. AbstractA 70 ‐year‐old woman with type 2 diabetes was admitted to Gifu University Hospital, Gifu, Japan, because of ketosis. She was diagnosed with type 2 diabetes at age 49 years and started insulin therapy at age 57 years, which restored glycemic control. Insulin therapy was discontinued and oral antid iabetes drugs, including sodium–glucose cotransporter 2 inhibitor dapagliflozin, were initiated at age 69 years. Thereafter, her bodyweight declined from 40.0 kg to 29.8 kg in 12 months; glycated hemoglobin remained>8.0%. On admission to our hospital, her laboratory tests and computed tomography scan showed ketosis, insulinopenia, and the presence of dehydration and bacterial pneumonia. She also lost substantial bodyweight and developed sarcopenia. The current case shows the importance of patient assessment before sodium –glucose cotransporter 2 inhibitor initiation in the elderly.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Case Report Source Type: research