Achievement of Insulin Reduction and Rapid Stabilization of Blood Sugar by Administering Insulin and GLP-1 Receptor Agonist in Type 2 Diabetes

A 63-year-old woman was admitted with complaints of thirst and polyuria about 1 year after ceasing therapy in November, X and in October, X+1. Her blood glucose levels at the beginning of her admissions were 347 at the first admission and 486 at the second admission. We administered glargine, a long-acting type insulin, 8U/day, and a short-acting insulin, glulisine, 4U/day, during the first admission. We administered glargine, a long-acting type insulin, 4U/day, and a short-acting insulin, glulisine, 3U/day, during the second admission. We also administered a GLP-1 receptor agonist, liraglutide, 0.3mg/day. Blood glucose levels (mg/dl) during the 5 days of the first admission were as follows: first, -, -, 347, and 180; second, 273, 266, 109, and 188; third, 75, 192, 186, and 182; fourth, 93, 194, 91, and 144; fifth, 78, 95, 124, and 127. In the second admission, blood glucose levels were as follows: first, -, -, 486, and 299; second: 140, 137, 195, and 128; third: 101, 122, 114, and 108; fourth: 101, 123, 123, and 137; and fifth, 89, 136, 111, and 129. CGM data showed an average of 128mg/dl and standard deviation of 34 during the first admission. CGM data showed an average of 125mg/dl and standard deviation of 20 during the second admission. The reduction of insulin and rapid flattening of blood sugar were achieved by GLP-1 receptor agonist with promotion of insulin secretion and suppression of glucagon secretion.