Combination Therapy With Semaglutide and Dapagliflozin as an Effective Approach for the Management of Type A Insulin Resistance Syndrome: A Case Report

Abstract

Type A insulin resistance (IR) syndrome is a very uncommon genetic disorder affecting the insulin receptor (INSR) gene, characterized by severe IR without the presence of obesity. Patients with this condition will eventually develop diabetes, presenting a variable response to insulin-sensitizers, such as metformin and thiazolidinediones, and high doses of insulin. We report for the first time the results of the use of combination therapy with a glucagon-like peptide-1 receptor agonist and a sodium-glucose cotransporter 2 inhibitor for the treatment of diabetes in the context of type A IR syndrome.

Monogenic diabetes clinic (MDC): 3-year experience

“…Individuals with type A insulin resistance may show severe hyperglycemia over time [ 27 ]; however, we do not know whether the early use of metformin in case 23 may prevent the onset of full-blown diabetes later in life. Recently, new therapies aimed at handling hyperinsulinemia and diabetes seen in patients with congenital SIR due to INSR mutations and in type A SIR have been proposed [ 28 , 29 ].…”

Frequency and characteristics of diabetes in lipodystrophies and insulin receptoropathies compared with type 1 and type 2: results from the multicenter DPV registry

“…In contrast to other types of diabetes, a significant number of patients with inborn defects of insulin signaling have been treated with SGLT2 inhibitors. This approach has been described in several case reports as a successful therapeutic approach in this disorder, as the glucosuric effect leads to an insulin receptor-independent lowering of blood glucose ( 25 , 26 , 27 , 28 ). In addition, SGLT2 inhibitors may be beneficial in this indication due to their positive effect on blood pressure ( 29 , 30 ).…”