Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Markedly Improved Glycemic Control and Enhanced Insulin Sensitivity in a Patient with Type 2 Diabetes Complicated by a Suprasellar Tumor Treated with Pioglitazone and Metformin
Naoya IGAKIMaki TANAKATakeo GOTO
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JOURNAL OPEN ACCESS

2005 Volume 44 Issue 8 Pages 832-837

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Abstract

A patient with type 2 diabetes and hypothalamic damage due to a suprasellar tumor developed impaired glycemic control and central obesity. The patient showed exaggerated adrenocorticotropic hormone responsiveness as determined by a corticotrophin releasing hormone test and elevated serum leptin concentrations associated with ravenous appetite and insulin resistance mediated in part through disturbances in leptin signaling. Combination treatment with metformin and pioglitazone was markedly effective in improving glycemic control. Additionally, metformin treatment showed marked anorectic effects on the hyperphagia. This case has important implications for the pathogenesis and management of diabetes in patients with hypothalamic-pituitary-adrenal axis deficiencies.

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© 2005 by The Japanese Society of Internal Medicine
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