Wada Makoto, Mizuno Yuri, Kajiyama Amika, Toriumi Shuji, Hashimoto Takahide, Ohtake Naoki, Yamaga Masaya, Yoshida Tomohiko, Murai Hiroyuki, Takemoto Minoru
Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare, Narita Hospital, Narita, JPN.
Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine, Chiba, JPN.
Cureus. 2025 Aug 12;17(8):e89954. doi: 10.7759/cureus.89954. eCollection 2025 Aug.
This case report describes a 61-year-old male with Charcot-Marie-Tooth disease type 1A (CMT1A) who developed poorly controlled type 2 diabetes mellitus. The patient, with a history of CMT1A, was admitted for preoperative glycemic management prior to lumbar spinal stenosis surgery, exhibiting an HbA1c of 8.1%. Treatment with metformin had been insufficient. Considering potential insulin resistance due to decreased skeletal muscle mass from CMT and reduced mobility, a combination therapy of the DPP-4 inhibitor sitagliptin and the SGLT2 inhibitor empagliflozin was initiated post-surgery, alongside diet and exercise. Notably, this combination effectively improved glycemic control without reducing skeletal muscle mass. This suggests that the combination of a DPP-4 inhibitor and an SGLT2 inhibitor may be a viable therapeutic option for managing diabetes mellitus in patients with CMT, warranting further investigation in larger studies due to the rarity of this comorbidity. Long-term glycemic control is crucial for maintaining activities of daily living (ADLs) and quality of life (QOL) in these patients.
本病例报告描述了一名患有1A型夏科-马里-图思病（CMT1A）的61岁男性，他患有控制不佳的2型糖尿病。该患者有CMT1A病史，因腰椎管狭窄手术前的术前血糖管理入院，糖化血红蛋白（HbA1c）为8.1%。二甲双胍治疗效果不佳。考虑到CMT导致骨骼肌质量下降和活动能力降低可能引起的胰岛素抵抗，术后开始使用二肽基肽酶-4（DPP-4）抑制剂西格列汀和钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂恩格列净进行联合治疗，并配合饮食和运动。值得注意的是，这种联合治疗有效地改善了血糖控制，且未减少骨骼肌质量。这表明DPP-4抑制剂和SGLT2抑制剂的联合可能是治疗CMT患者糖尿病的一种可行治疗选择，鉴于这种合并症的罕见性，需要在更大规模的研究中进一步调查。长期血糖控制对于维持这些患者的日常生活活动（ADL）和生活质量（QOL）至关重要。
