Effectiveness of Sitagliptin and Empagliflozin Combination Therapy in a Patient With Charcot-Marie-Tooth Disease and Comorbid Diabetes Mellitus: A Case Report

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.