Additional Treatment With Heparin and Warfarin Also Improves T2DM and Partially Resolves Ascending Aortic Thrombi: A Case Report

Type 2 diabetes mellitus (T2DM) is a common disease and a clinically significant problem. When patients are treated with antidiabetic medications, issues related to target blood glucose levels can arise. Although achieving lower glucose targets is beneficial, it increases the risk of hypoglycemia. Because conventional treatments are often ineffective in addressing this issue, new strategies are needed. Heparin-warfarin treatment partially resolved portal vein thromboses (PVTs); subsequently, I unexpectedly observed that heparin-warfarin therapy could ameliorate mild to moderate T2DM, reducing the need for antidiabetic medications to one or none. One to two weeks after initiating heparin-warfarin treatment, I had to reduce the use of diabetes medications to one or zero to continue the therapy and avoid hypoglycemia. It remains unclear whether additional heparin-warfarin treatment can further improve glycemic control in patients who require only one diabetes medication. A 72-year-old male with a history of cerebral infarction and T2DM was initially treated with heparin-warfarin and later received additional heparin-warfarin therapy to resolve PVTs. The patient underwent transesophageal echocardiography and cardiac CT to assess chronic thrombi. Heparin-warfarin treatment improved T2DM and partially resolved PVTs and thrombi in the ascending aorta (AAo). With additional therapy, T2DM further improved, allowing a reduction in diabetes medications from 3 to 0. After discontinuation of diabetes medication, the patient experienced neither hypoglycemia nor hyperglycemia, and blood glucose levels ranged from 90 to 120 mg/dL before meals. Some thrombi were partially resolved. Overall, additional heparin-warfarin therapy improved the patient's T2DM, reduced the need for diabetes medications from three to none, and partially resolved PVTs and AAo thrombi. Heparin-warfarin therapy may represent a safer and more effective option for patients with T2DM.