A Case of Diabetes Mellitus associated with Werner's syndrome successfully treated with CS-045 (Troglitazone)

Abstract

A 48-year-old woman with diabetes associated with Werner's syndrome was admitted to Nagasaki University Hospital because of poorly controlled diabetes. After admission, she was treated with a 1200 kcal diet and exercise therapy. Her mean plasma glucose (PG) decreased from 276mg/dl to 232mg/dl within 3 weeks, but was unchanged at 6 weeks (229mg/dl). The new oral hypoglycemic agent CS-045 (Troglitazone) was then administered'. After CS-045 (400mg/day), mean PG decreased markedly (152mg/dl 3 weeks after starting CS-045 versus 137mg/dl 6 weeks).
The area under the insulin curve (AUC insulin) during 75g OGTT was measured to assess insulin secretion. AUC insulin increased from 4573μU/ml·min to 7497μU/ml after diet therapy. AUC insulin after taking CS-045 also increased (8646μU/ml·min), but the degree of the increment was smaller than after diet therapy. Insulin sensitivity was measured using Bergman's minimal model. The insulin sensitivity index (Si) on admission was less than 0.01×10^-4min^-1·pM^-1. Si after diet therapy increased (0.37×10^-4min^-1·pM^-1). Si after taking CS-045 increased markedly, from 0.37×10^-4min^-1·pM^-1 to 2.67×10^-4min^-1·pM. This patient's diabetes was successfully treated by CS-045, and the mechanism of the decrease in plasma glucose was thought to be improvement of insulin sensitivity and glucose toxicity.