CASE REPORT - THERAPEUTICAL OPTIONS FOR OPTIMIZING THE GLYCEMIC PROFILE IN A PATIENT WITH TYPE 2 DIABETES MELLITUS
Incretin-based therapies address some of the mechanisms of T2DM by improving - cell function, inhibiting glucagon secretion, stimulating insulin secretion, reducing appetite and promoting weight loss. We present the case of a patient with type 2 diabetes mellitus who was admitted in the Diabetes, Nutrition and Metabolic Diseases Clinic for high blood glucose values and polyuria. Because the patient had high glycemic values during self-monitoring of blood glucose (SMBG) and also symptoms of hypoglycemia, we decided to evaluate the glycemic variability using the recordings of the continuous glucose monitoring system (CGMS). The CGMS indicated that the patient had episodes of hypoglycemia and also high glucose values. The treatment was changed and the therapy with exenatide was initiated together with reinforcement of lifestyle optimization. The CGMS and SMBG three months after the treatment change indicated the improvement of glycemic control, weight reduction and cardiovascular risk reduction. The GLP-1 receptor agonists are a very good therapeutical option in subjects with T2DM where the HbA1c value is not very high, the duration of T2DM is small, weight loss is a very important issue and there is a high risk of hypoglycemia.