RESUMO
BACKGROUND: A detailed description is given of a case we encountered in which unexpectedly marked weight gain occurred following a treatment switch from a GLP-1 receptor agonist to an SGLT-2 inhibitor CASE REPORT: The patient, a 44-year-old man with type 2 diabetes mellitus, had gained about 10 kg in weight in the previous year. Therefore, metformin was replaced with liraglutide to obtain reduction of body weight. Although the patient lost about 8 kg (7%), during the 18-month period on the medication, the weight loss stabilized; therefore, the treatment was again switched to tofogliflozin to obtain further reduction of body weight. However, the patient reported increasing hunger and an exaggerated appetite from week 3 onward after the start of tofogliflozin, and gained about 9 kg in weight within 2 weeks, associated with a tendency towards increased HbA1c; therefore, tofogliflozin was discontinued. Immediate reinstitution of liraglutide resulted in reduction of the increased appetite, weight, and HbA1c level. CONCLUSIONS: Caution should be exercised against hyperphagia and weight gain due to hunger that may occur following discontinuation of a GLP-1 receptor agonist and/or initiation of an SGLT-2 inhibitor.
Assuntos
Compostos Benzidrílicos/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Glucosídeos/efeitos adversos , Hiperfagia/induzido quimicamente , Transportador 1 de Glucose-Sódio/antagonistas & inibidores , Aumento de Peso/efeitos dos fármacos , Adulto , Compostos Benzidrílicos/uso terapêutico , Glucosídeos/uso terapêutico , Humanos , Hiperfagia/metabolismo , MasculinoRESUMO
A concise liquid-phase combinatorial synthesis of all stereoisomers of Tenuecyclamide A was achieved using a mixture of D-/L-alanine with each stereoisomer encoded by a different f-Fmoc tag. The synthetic strategy using f-Fmoc reagents as the protecting group for amino acids has been demonstrated to be a useful method for diverse polypeptide analogue synthesis.
Assuntos
Alanina/química , Peptídeos Cíclicos/síntese química , Peptídeos/síntese química , Tiazóis/síntese química , Peptídeos/química , Peptídeos Cíclicos/química , Estereoisomerismo , Tiazóis/químicaRESUMO
A novel and efficient oxidative biaryl coupling reaction of phenol ether derivatives using a combination of hypervalent iodine(III) reagent, phenyliodine(III) bis(trifluoroacetate) (PIFA), and heteropoly acid has been developed.
Assuntos
Compostos Heterocíclicos com 3 Anéis/síntese química , Alcaloides/síntese química , Fatores Biológicos/síntese química , Ciclização , Indicadores e Reagentes , Iodo/química , Oxigênio/química , Fenol/química , Polieletrólitos , Polímeros/químicaRESUMO
The oxidative intramolecular coupling reaction of phenol ether derivatives (nonphenolic derivatives) on treatment with a novel combination of a hypervalent iodine(III) reagent, phenyliodine bis(trifluoroacetate) (PIFA), and heteropoly acid (HPA) was studied. Biaryl compounds were obtained in excellent yields on treatment of highly substituted phenol ethers. On the other hand, spirodienones were specifically formed when one of the preferred arylic coupling sites was substituted with a methoxy group in the para position.