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Semaglutide is effective in type 2 diabetes and obesity with schizophrenia

Diabetology International (2022)Cite this article

Abstract

Background

Prevention and treatment of type 2 diabetes and obesity are problematic for individuals with schizophrenia partly because atypical antipsychotics and mental distress themselves increase appetite, thus promoting subsequent body weight gain and deterioration of glycemic control. Glucagon-like peptide-1 (GLP-1) receptor agonists have been gaining attention for their glucose-lowering and body weight-reducing effects in obese individuals with type 2 diabetes generally, but their effects in those also having schizophrenia have not been adequately addressed.

Case presentation

This case was a 50-year-old obese woman having type 2 diabetes and schizophrenia. Although she was receiving oral anti-diabetes treatment, her HbA1c remained inadequately controlled (8.0–9.0%) partly due her difficulty in following instructions on heathy diet and exercise. In addition, she was repeatedly hospitalized due to suicide attempts by overdosing on her anti-psychotic and anti-diabetes drugs. Her HbA1c was elevated to as high as 10.2% despite the use of multiple anti-diabetes drugs including the GLP-1 receptor agonist dulaglutide, and she was hospitalized in our department. We chose the GLP-1 receptor agonist semaglutide to replace dulaglutide along with a multidisciplinary team approach that included a cognitive–behavioral therapist. The patient perceived that her hunger was suppressed when she started receiving semaglutide 0.5 mg. After discharge, semaglutide was remarkably more effective than dulaglutide in that it reduced and maintained the patient’s HbA1c and body weight for 6 months after initiation of the drug.

Conclusion

The GLP-1 receptor agonist semaglutide can be effective in maintaining appropriate control of glycemia and body weight in diabetes and obesity with schizophrenia.

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Fig. 1

Availability of data and materials

Clinical data from the corresponding author are available upon request.

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Acknowledgements

The authors are grateful to the patient for her contribution to this study. The authors also thank J. Kawada, H. Tsuchida and M. Kato for their technical assistance, and M. Yato, Y. Ogiso, and M. Nozu for secretarial assistance.

Funding

This work was supported by grants from Japan Society for the Promotion of Sciences (JSPS) [KAKENHI Grant Number: 26111004 (DY) and 20K19673 (LY)], and Grants for young researchers from Japan Association for Diabetes Education and Care (TK).

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Authors and Affiliations

  1. Department of Diabetes, Endocrinology and Metabolism, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan

    Kaoru Noda, Takehiro Kato, Nao Nomura, Mayu Sakai, Sodai Kubota, Tokuyuki Hirose, Yanyan Liu, Yoshihiro Takahashi, Ken Takao, Masami Mizuno, Takuo Hirota, Tetsuya Suwa, Yukio Horikawa & Daisuke Yabe

  2. Department of Rheumatology and Clinical Immunology, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan

    Kaoru Noda, Takehiro Kato, Nao Nomura, Mayu Sakai, Sodai Kubota, Tokuyuki Hirose, Yanyan Liu, Yoshihiro Takahashi, Ken Takao, Masami Mizuno, Takuo Hirota, Tetsuya Suwa, Yukio Horikawa & Daisuke Yabe

  3. Yutaka Seino Distinguished Center for Diabetes Research, Kansai Electric Power Medical Research Institute, Kobe, Japan

    Sodai Kubota & Daisuke Yabe

  4. Center for Healthcare Information Technology, Tokai National Higher Education and Research System, Nagoya, Japan

    Daisuke Yabe

  5. Division of Molecular and Metabolic Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Daisuke Yabe

Authors
  1. Kaoru Noda
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  2. Takehiro Kato
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  3. Nao Nomura
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  4. Mayu Sakai
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  5. Sodai Kubota
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  6. Tokuyuki Hirose
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  7. Yanyan Liu
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  8. Yoshihiro Takahashi
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  9. Ken Takao
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  10. Masami Mizuno
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  11. Takuo Hirota
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  12. Tetsuya Suwa
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  13. Yukio Horikawa
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  14. Daisuke Yabe
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Contributions

KN, TK and DY contributed to the analysis, collection, and interpretation of data and writing of the manuscript. NN, MS, SK, TH, YL, YT, KT, MM, TH, TS and YH contributed to the analysis, collection of data, and interpretation of data as well as critical revisions of the manuscript for important intellectual content, and contributed to the analysis, collection and interpretation of pathological data and provided critical revisions of the manuscript for important intellectual content. All authors approved the version to be published. TK and DY are the guarantors of this work.

Corresponding author

Correspondence to Takehiro Kato.

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Conflict of interest

DY has received consulting/lecture fees from Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co. Ltd., and Takeda Pharmaceutical Company Limited. DY also received grants from Arkray Inc., Novo Nordisk Pharma Ltd., Nippon Boehringer Ingelheim, Ono Pharmaceutical Co. Ltd., Taisho Pharmaceutical Co. Ltd., Takeda Pharmaceutical Company Limited, and Terumo Corporation. YH received lecture fees from Kowa and MSD. KN, TK, NN, MS, SK, TH, YL, YT, KT, MM, TH, KI and TS declare that they have no conflict of interest. All authors declare that they have no competing interests relevant to this study.

Ethics approval and consent to participate

Formal ethics approval was waived for this paper by the ethics committee of Gifu University Graduate School of Medicine due to its being a case report.

Compliance with ethical guidelines

All procedures performed in studies involving human participants followed the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the patient.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

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Cite this article

Noda, K., Kato, T., Nomura, N. et al. Semaglutide is effective in type 2 diabetes and obesity with schizophrenia. Diabetol Int (2022). https://doi.org/10.1007/s13340-022-00590-1

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Keywords

  • GLP-1 receptor agonist
  • Schizophrenia
  • Obesity
  • Type 2 diabetes
  • Bodyweight