Related Experiment Video
Updated: Dec 30, 2025

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
HYPOTHYROIDISM COULD BE A POTENTIAL FACTOR TO PROLONG SUBCUTANEOUS NODULES OF EXENATIDE ONCE WEEKLY: A CASE REPORT
Objective:
Exenatide once weekly (ExeOW) is one of the long-acting glucagon-like peptide 1 receptor agonists. Embedding exenatide in poly(D,L-lactide-co-glycolide) microspheres enables the once-weekly subcutaneous injection of exenatide as a treatment for diabetes. We report a case of a patient with type 2 diabetes and hypothyroidism who developed long-standing subcutaneous nodules after treatment by ExeOW injection.
Methods:
Case report and review of the literature. A 57-year-old Japanese man with type 2 diabetes treated with ExeOW and primary hypothyroidism.
Results:
We observed multiple subcutaneous nodules remaining at the ExeOW injection site for >10 weeks. As the patient's thyroid hormone levels normalized, these nodules decreased and disappeared, and his hemoglobin A1c levels improved.
Conclusion:
The patient's clinical course suggests that the hydrolysis of ExeOW at the site of injection may be inhibited by concomitant hypothyroidism, in which glycosaminoglycans including hyaluronic acid are known to accumulate (including in the skin). This case may indicate that hypothyroidism prolongs the existence of subcutaneous nodules from ExeOW treatment.
Related Concept Videos
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
Drug Accumulation During Multiple Dosing: Repetitive IV Injections
Drug Dosing: Obese Patients
Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
The Thyroid Gland
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

