Abstract
This report presents a case of 54-year-old obese female with type 2 diabetes. She had been diagnosed to have diabetes at the age of 37, and immediately treated with metformin. Glimepiride and pioglitazone were added at the age of 47 and 53, respectively. However, her glycemic control remained poor with HbA1c between 11.5～12.2 %. She received 3 mg glimepiride, 750 mg metformin, and 15 mg pioglitazone, in January 2011; however, her HbA1c was 12.1 %. Liraglutide was administered at an initial dose of 0.3 mg up to 0.9 mg per day, and metformin and pioglitazone were discontinued according to the package insert of liraglutide. There was improvement of hyperglycemia and an increase in plasma insulin levels not only after fasting but also in the post prandial state. However, markers of insulin resistance rapidly worsened. Therefore, insulin resistance must be evaluated as well as glycemic control in obese patients with type 2 diabetes that are treated with insulin sensitizers if the administration of liraglutide is considered.
