Pathophysiological mechanisms and benefits of SGLT‑2 inhibitors in a patient with cerebral artery aneurysm: A case report

The present study described the case of a 50-year-old male patient. The patient had type 2 diabetes since the age of 38 years (in 2013) with an initial elevated glycated hemoglobin A1c of 7.2%, with a significant cardiovascular (CV) history consisting of an aneurysm of the anterior communicating artery that had been operated on in 1998 and a ruptured basilar artery tip aneurysm embolized with a stent in 2013; the case was also associated with bronchiectasis (since 2020), non-alcoholic fatty liver disease (since 2018), diabetic neuropathy (since 2023) and obesity with a body mass index of 31.72 kg/m² (since 2010). Over the years the patient exhibited good metabolic control, initially treated with Metformin and managed through a change of diet. However, due to intolerance to Metformin, the patient stopped receiving treatments and only managed his diet. Since diabetes is by definition a condition that implies a high CV risk by itself, the primary focus with this patient was to provide additional CV protection, particularly secondary protection against any other potential future, and possibly fatal, CV events. After a brief introduction regarding the available therapeutic options, the case is presented along with the medical history, concomitant medications and evolution after 1 year. In the discussion section, similar documented cases in the literature were compared with the present case, and the potential effects of the therapeutic intervention in the present study were compared.