title: Effective weight loss after treatment with a glucagon-like peptide-1 receptor agonist in a morbidly obese and diabetic patient before bariatric surgery: a case report.
abstract: BACKGROUND
  Glucagon-like peptide-1 receptor agonists, a new class of anti-diabetic drugs, are widely used in the treatment of type 2 diabetes. However, the effect of glucagon-like peptide-1 receptor agonists on the treatment of preoperative weight loss in obese type 2 diabetic patients has not been reported.
  
  
  METHODS
  A 38-year-old Taiwanese woman presented to our hospital with morbid obesity and type 2 diabetes mellitus. Bariatric surgery was recommended by a general surgery specialist. Weight loss before surgery was recommended to reduce the frequency of surgical complications. In addition to diet control with lifestyle modifications, pharmacological treatment with metformin and glucagon-like peptide-1 receptor agonists was administered. Fourteen months of treatment reduced her hemoglobin A1c level from 7.4 to 5.5% and reduced her body weight by 21.2 kg.
  
  
  CONCLUSIONS
  One year of diet control with lifestyle modifications and pharmacological treatment with glucagon-like peptide-1 receptor agonists and metformin markedly decreased hemoglobin A1c levels and resulted in effective and substantial weight loss in a morbidly obese patient with dysregulated diabetes during the preoperative period.
authors.forename: Jui-Hung
authors.initials: JH
authors.lastname: Chen
authors.forename: Wen-Hao
authors.initials: WH
authors.lastname: Tang
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No, 325, Sec, 2, ChengGong Rd, NeiHu District, Taipei City 114, Taiwan. doc10383@gmail.com.
authors.forename: Chien-Hsing
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D000077270:Exenatide; D005260:Female; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use; D009767:Obesity, Morbid / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D010455:Peptides / Q000627:therapeutic use*; D011300:Preoperative Care / Q000379:methods*; D018027:Receptors, Glucagon / Q000819:agonists*; D014688:Venoms / Q000627:therapeutic use*; D015431:Weight Loss
chemical_list: C000593833:GLP1R protein, human; D000067757:Glucagon-Like Peptide-1 Receptor; D007004:Hypoglycemic Agents; D010455:Peptides; D018027:Receptors, Glucagon; D014688:Venoms; D008687:Metformin; D000077270:Exenatide