Treatment of a case of severe insulin resistance as a result of a PIK3R1 mutation with a sodium-glucose cotransporter 2 inhibitor

Journal of Diabetes Investigation
Tetsushi HamaguchiWataru Ogawa

Abstract

A Japanese woman aged in her late 30s with severe insulin resistance and bodily features including a triangular face, prominent forehead, small chin, large and low-set ears, and ocular depression was investigated. A similar phenotype was not observed in other family members with the exception of her son, suggesting that the condition was caused by a de novo mutation that was transmitted from mother to son. Exome analysis showed the presence in the proband and her son of a c.1945C>T mutation in PIK3R1, a common mutation associated with SHORT (short stature, hyperextensibility of joints and/or inguinal hernia, ocular depression, Rieger anomaly, and teething delay) syndrome. Administration of a sodium-glucose cotransporter 2 inhibitor lowered the proband's hemoglobin A1c level and allowed a reduction in her insulin dose without treatment-related adverse events including ketoacidosis, exaggerated loss of body mass or hypoglycemia. Sodium-glucose cotransporter 2 inhibitors might thus offer an additional option for the treatment of genetic syndromes of severe insulin resistance.

References

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Citations

Nov 5, 2019·Journal of Diabetes Investigation·Takehito TakeuchiHideki Katagiri
May 30, 2020·Journal of Diabetes Investigation·Yusei Hosokawa, Wataru Ogawa
May 23, 2020·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Christos BagiasStelios Tigas
Nov 26, 2020·International Journal of Molecular Sciences·Birgit KnebelJorg Kotzka
Jul 13, 2021·Frontiers in Pediatrics·Shin-Hee KimDae-Hyun Jang

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