title: [A case of an elderly diabetic patient with dementia effectively treated with weekly exenatide].
abstract: A 74-year-old man with diabetes mellitus since 64 years of age had been treated with glimepiride, metformin and alogliptin; however, his glycemic control remained poor, i.e., a casual blood glucose level of 318 mg/dl, HbA1c level of 10.6% and glycated albumin level of 24.9%. Although his blood glucose level improved with intensive insulin therapy, he exhibited dementia with an MMSE score of 9/30 and was unable to continue insulin injections by himself, thus rejecting his family's help. The extended-release form of the GLP-1 agonist exenatide (Bydureon(®)) was recently introduced in Japan. This new anti-diabetic agent enables the administration of once-weekly type 2 diabetes treatment that delivers a continuous dose of exenatide in a single weekly injection. We employed weekly exenatide therapy in combination with oral hypoglycemic agents in this case. The patient visited our outpatient clinic for injections every week, showing a remarkable improvement in his HbA1c level, from 10.7% to 7.1% in five months. Subcutaneous induration was the only side effect of weekly exenatide injection. Weekly exenatide therapy can be easily managed by other caregivers and is expected to be a useful treatment approach in elderly diabetic patients with dementia.
authors.affiliation: Department of Endocrinology and Metabolism, Kanto Central Hospital.
authors.forename: Satoko
authors.initials: S
authors.lastname: Maruyama
authors.forename: Yuya
authors.initials: Y
authors.lastname: Tsurutani
authors.forename: Mai
authors.initials: M
authors.lastname: Kondo
authors.forename: Naoko
authors.initials: N
authors.lastname: Sagawa
authors.forename: Akira
authors.initials: A
authors.lastname: Sata
authors.forename: Mariko
authors.initials: M
authors.lastname: Miyao
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D003704:Dementia / Q000150:complications*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy*; D000077270:Exenatide; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010455:Peptides / Q000008:administration & dosage / Q000627:therapeutic use*; D014688:Venoms / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D000077270:Exenatide