Internal medicine (Tokyo, Japan) · 2018
Suppression Failure of Cortisol Secretion by Dexamethasone May Occur in Glucagon-like Peptide-1 Receptor Agonist-treated Patients with Diabetic Autonomic Neuropathy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Nagai Yasuki, Mukai Kosuke, Otsuki Michio, Kimura Takekazu, Kozawa Junji, Nishizawa Hitoshi, Maeda Norikazu, Matsuoka Taka-Aki, Iwahashi Hiromi, Imagawa Akihisa, Shimomura Iichiro
Аннотация
Two diabetic women (case 1, 75 years old; case 2, 49 years old) being treated with glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs) showed no suppression of cortisol secretion on a dexamethasone suppression test (DST). However, its secretion was suppressed after switching from GLP-1 RAs to insulin. We also checked the cortisol secretion by a DST in five consecutive inpatients (case 3-7) being treated with GLP-1 RAs. The coefficients of R-R interval variation at rest and during deep breathing were lower in the two false-positive cases (case 1 and 2) than in the five true-negative cases (case 3-6). GLP-1 RAs can be switched to insulin in order to eliminate the slow absorption effect of dexamethasone by GLP-1 RAs if a DST is planned in diabetic patients receiving GLP-1 RAs.