Successful treatment of a case of Congenital Lipodystrophy with 1 mg subcutanous Semaglutide

Abstract

Abstract 25-year-old female presented to the endocrine clinic suffering from uncontrolled blood sugar and irregular period, she was diagnosed with type 1 diabetes since she was 15 and treated with premixed insulin, on the other hand she was diagnosed with polycystic ovary syndrome and treated with oral contraceptive pills, on examination; there is acanthosis nigricans in the axilla and forearm, android lean body habitus and acromegalic face, hirsutism and prominent veins. Labs revealed high triglyceride (more than 1000 mg/dL), high fasting insulin, high total testosterone 0.9 ng/mL, HbA1c 14,5%, high ALT, albuminuria, she is using very high doses of insulin yet uncontrolled, we diagnosed her as generalized lipodystrophy, the drug of choice is metroleptin which is not available, so I started pioglitazone 45 mg with semaglutide 1mg, gradually weaned off insulin. After 3 months of treatment her HbA1c declined to 7 without insulin, triglyceride to 422 mg/dL, proteinuria declined but was not normalized. We postulate the hypothesis that the insulin sensitizing properties of GLP1 agonist in the treatment of insulin resistance syndromes can be implemented particularly in countries with middle and low socioeconomic status that don't have access to the expensive drugs. Figure 1. Patient footage oral consent taken. Table 1.Results of biochemical parameters before and after treatment.