Case Report : Exenatide Combined with Metformin and Glimepiride Allows Successful Weaning from Insulin in an Obese Diabetic Patient with Klinefelter Syndrome

Klinefelter syndrome is the most common numerical sex chromosome disorder. Affected males have an additional X chromosome, resulting in a tall and slender build, hypogonadism, gynecomastia, small testes, sparse body hair, diminished libido, and infertility. It has been reported that patients with Klinefelter syndrome tend to develop diabetes mellitus. Here, we report a 59-year-old man who had Klinefelter syndrome and type 2 diabetes with a body mass index (BMI) of 36.0 kg/m 2 . Glycemic control was poor despite high-dose insulin therapy (150 units daily). Administration of the GLP-1 analog exenatide together with metformin and glimepiride improved his glycemic control, and allowed weaning from insulin. Interestingly, his weight decreased by 17.5 kg during hospitalization for 39 days, but the patient did not complain of hunger. In conclusion, GLP-1 analog may be a therapeutic option for obese diabetic patients with Klinefelter syndrome.