A Case of Type 2 Diabetes With Short Bowel Syndrome in Which GLP-1 Receptor Agonist Treatment Improved the Nutritional Status

Abstract

Patients with short bowel syndrome (SBS) are forced to restrict their activities due to deficiency of various nutrients and severe diarrhea, and have a poor prognosis due to complications of long-term TPN. We experienced the case of a type 2 diabetic patient with SBS who used liraglutide, which has an inhibitory effect on gastric emptying, and improved his nutritional status by improving his absorption disorder. The patient was a 66-year-old man who had been diagnosed with diabetes in 2008. After partial resection of the small intestine due to small intestinal bleeding in 2015, a fistula was found in the rectum, and a stoma was constructed. The remaining small intestine was 80 cm. Since that time, oral intake and total parenteral nutrition had been performed. When subcutaneous injection of liraglutide was started in 2018, the drainage from the stoma decreased from 3000-4000 mL to approximately 1000 mL, and the renal function and serum albumin level improved. GLP-1 receptor agonists can improve the clinical symptoms and quality of life of SBS patients, and may represent a new treatment option.