Efficacy and safety of <scp>SGLT2</scp> inhibitor on insulin resistance and hyperglycemia in Werner syndrome—A case report

A 48-year-old man was referred to our hospital due to hyperglycemia. His casual plasma glucose and glycated hemoglobin A1c were 25.2 mmol/L and 8.7%, respectively. He had undergone bilateral cataract surgery in his 30s. He exhibited a bird-like face contour, gray hair, alopecia, and bilateral calcifications of the Achilles' tendons, suggestive of Werner syndrome (WS). Genetic analysis revealed compound heterozygous mutations in the WRN gene (mutation c. 3139-1G>C, mutation c. 1105C>T), leading to the diagnosis of WS. Adequate glycemic control was not achieved by the treatment with pioglitazone and metformin. Additional administration of dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, ameliorated insulin resistance and resulted in an improvement in glycemic control without adverse events. Dapagliflozin may potentially be a choice in treating diabetes associated with WS with an amelioration of insulin resistance.