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Medical Science Monitor Basic Research


Body Weight Gain and Hyperphagia After Administration of SGLT-2 Inhibitor: A Case Report

Unusual clinical course, Unusual or unexpected effect of treatment, Unexpected drug reaction , Educational Purpose (only if useful for a systematic review or synthesis)

Hiromi Hamamoto, Mitsuhiko Noda

Japan Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan

Am J Case Rep 2015; 16:863-867

DOI: 10.12659/AJCR.896233

Available online:

Published: 2015-12-07


BACKGROUND: A detailed description is given of a case we encountered in which unexpectedly marked weight gain occurred following a treatment switch from a GLP-1 receptor agonist to an SGLT-2 inhibitor
CASE REPORT: The patient, a 44-year-old man with type 2 diabetes mellitus, had gained about 10 kg in weight in the previous year. Therefore, metformin was replaced with liraglutide to obtain reduction of body weight. Although the patient lost about 8 kg (7%), during the 18-month period on the medication, the weight loss stabilized; therefore, the treatment was again switched to tofogliflozin to obtain further reduction of body weight. However, the patient reported increasing hunger and an exaggerated appetite from week 3 onward after the start of tofogliflozin, and gained about 9 kg in weight within 2 weeks, associated with a tendency towards increased HbA1c; therefore, tofogliflozin was discontinued. Immediate reinstitution of liraglutide resulted in reduction of the increased appetite, weight, and HbA1c level.
CONCLUSIONS: Caution should be exercised against hyperphagia and weight gain due to hunger that may occur following discontinuation of a GLP-1 receptor agonist and/or initiation of an SGLT-2 inhibitor.

Keywords: Diabetes Mellitus, Type 2 - drug therapy, Benzhydryl Compounds - therapeutic use, Adult, Glucosides - therapeutic use, Hyperphagia - metabolism, Sodium-Glucose Transporter 1 - antagonists & inhibitors, Weight Gain - drug effects