Case Diagnosis: We will discuss the cases of 2 tetraplegics with obesity that were treated with glucagon like peptide 1 (GLP-1) inhibitor medications with safe outcomes.
Case Description: These patients were screened before starting the medication and carefully monitored for side effects while the medications were being administered. One of the patients, who was not a diabetic felt intermittent hypoglycemic symptoms after an overnight fast while on the GLP-1 inhibitor. Her blood glucose levels were checked and remained between 65-80 during these episodes and improved with eating breakfast. Regardless of this symptom, she was able to continue the medication and has continued to experience weight loss. The other patient tolerated the medication without symptoms of hypoglycemia and has also demonstrated weight loss.
Discussions: GLP-1 inhibitor medications have become mainstream in recent years as a weight loss treatment. The safety and efficacy of these medications have not been studied in the tetraplegic population. Given the decreased mobility that comes with tetraplegia it is reasonable that this population may respond differently than the ambulatory population when prescribed these medications.
Conclusions: Further evaluation of the use of GLP-1 inhibitor medication administration for weight loss in the paralyzed population warrants study. Although these 2 cases demonstrate safety and effectiveness, this is too small of a sample to draw any conclusions about the tolerance of these medications in general. Future research, especially regarding the possible detrimental weight gain if a GLP-1 medication is discontinued is worth considering, especially because weight gain in a population that already has severe functional impairments may make mobility and completion of activities of daily living even more challenging.
