Case Report: Efficacy and safety of dose-escalated Mazdutide, a GLP-1/GCGR dual agonist, in an adolescent with obesity, type 2 diabetes, and hyperuricemia.
This case report describes the use of Mazdutide, a dual glucagon-like peptide-1/glucagon receptor (GLP-1/GCGR) agonist, in a 15-year-old male presenting with obesity (BMI 30.64 kg/m²), type 2 diabetes (HbA1c 9.60%), and hyperuricemia (serum uric acid 511 µmol/L). The patient received a dose-escalation regimen of subcutaneous once-weekly Mazdutide alongside metformin and insulin over 36 weeks. The authors report substantial improvements across multiple metabolic parameters: body weight decreased by 16.8 kg (18.89% BMI reduction), HbA1c fell by 21.88%, and serum uric acid dropped by 37.00%. Lipid outcomes also improved, with triglycerides declining 69.02%, total cholesterol 13.65%, and LDL cholesterol 17.27%. Hepatic steatosis, confirmed by ultrasound, resolved by week 14. No hypoglycemic episodes or other adverse events were reported, and benefits were described as sustained after treatment ended. Key limitations include the single-patient design, the absence of a control condition, and the concurrent use of metformin and insulin, making it impossible to attribute outcomes specifically to Mazdutide. These preliminary observations may inform future controlled studies in adolescent populations.
Why this grade: A single adolescent case with no control arm and concurrent medications prevents causal attribution or generalization of findings.
Objective Mazdutide, a glucagon-like peptide-1/glucagon receptor (GLP - 1/GCGR) dual agonist, has shown marked efficacy in glycemic control, weight loss, and metabolic improvement in adults. However, data in adolescents remain limited. This report explores its therapeutic potential in an adolescent with obesity-related type 2 diabetes mellitus (T2DM) and hyperuricemia (HUA). Study design and methods We report the case of a 15-year-old male patient diagnosed with obesity (BMI: 30.64 kg/m²), type 2 diabetes mellitus (HbA1c: 9.60%), and hyperuricemia (serum uric acid: 511 μmol/L). The patient underwent a dose-escalation regimen of Mazdutide (2 mg → 4 mg → 6 mg, administered subcutaneously once weekly) in combination with metformin and insulin to evaluate therapeutic efficacy and safety outcomes. Results After 36 weeks, the patient showed significant improvement: weight decreased by 16.8 kg (18.89% BMI reduction), uric acid dropped by 37.00%, and HbA1c fell by 21.88%. No hypoglycemic episodes occurred. Lipid levels improved notably: triglycerides fell by 69.02%, total cholesterol by 13.65%, and LDL cholesterol by 17.27%. Hepatic steatosis resolved by week 14, as confirmed by ultrasound. No adverse events were reported, and benefits were sustained post-treatment. Conclusions Mazdutide exhibited robust metabolic efficacy and good tolerability in an adolescent with obesity, T2DM, and HUA. It improved glycemic control, reduced weight and uric acid, reversed steatosis, and modulated lipid profiles. These findings support its potential as a comprehensive treatment for adolescent metabolic disorders.
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