持効型インスリン注射併用薬をDPP-4 阻害薬からGLP-1 受容体作動薬へ切り替え著効を得た糖尿病血液透析患者の1 例

A diabetic female patient in her 80s being treated with sustained insulin and a dipeptidyl peptidase-4（DPP-4）inhibitor was undergoing hemodialysis. However, her level of glycated albumin（GA）, an indicator of glycemic control in diabetic patients undergoing hemodialysis, was greater than 25%; therefore, insulin was increased. Since GA did not decrease even with the increase in insulin, her diabetes medication was switched from a DPP-4 inhibitor to glucagon-like peptide-1（GLP-1）receptor agonist without a change in the units of insulin. GA subsequently decreased, and blood glucose（BG）control improved with no hypoglycemia. When the effects of medication are insufficient, a change to that with different actions may be effective. Therefore, a switch to medication with different actions needs to be considered in order to obtain better therapeutic effects