Introduction: Inhibitors of sodium-dependent glucose co-transporter 2 (SGLT2i) reduce circulating glucose concentrations via a renal mechanism. Its metabolic effects have not been fully described and there is a discrepancy on some clinical results found in studies on SGLT2i. Our aims were to detect if there are some predictor factors to identify what patients will have higher response to dapagliflozin, a SGLT2i, and second, to explore whether intensity of glycosuria is correlated to the intensity of metabolic and anthropometric changes.
Methods/design: 23 participants with type 2 diabetes (T2D) (age: 53.1±7.6 years; 56.5% males, T2D duration 12.1±6 years) received dapagliflozin (10 mg/day) for 18 weeks in conditions of normal medical practice. Parameters related to glucose metabolism, renal function and anthropometric variables were measured at baseline and at week 18. Glycosuria was quantitatively measured at baseline and at the end of the follow-up.
Results: At week 18, glycosuria increased from 6.4±2.2 to 68.9±50.4 g/24 (P<0.001). Significant reductions in body mass index (BMI), HbA1c, fasting plasma glucose (FPG) were observed (P<0.01). Quantitative glucose urine levels at week 18 positively correlated with the following variables at baseline: FPG (r=0.631; P=0.001), HbA1c (r=0.399; P=0.03), glycosuria (r=0.397; P=0.034) and inversely correlated with albumin/creatinine ratio (r=−0.409; P=0.037) but not with age, T2D duration, eGFR or BMI. Intensity of glycosuria correlated with diuresis increase (r=−0.602; P=0.002) but didnt with and HbA1c or BMI falls.
Conclusions: Glycosuric effect of dapagliflozin is correlated with glycemic control at baseline independently of time of T2D evolution as result of a higher expression of SGLT2 receptors in poorly controlled diabetic patients. The magnitude of glycosuria did not provide higher weight loss or higher falls in HbA1c.
20 - 23 May 2017
European Society of Endocrinology