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Yamada K, Nakayama H, Yoshinobu S, et al. Effects of a sodium glucose co-transporter 2 selective inhibitor, ipragliflozin, on the diurnal profile of plasma glucose in patients with type 2 diabetes: A study using continuous glucose monitoring. J Diabetes Investig. 2015;6(6):699-707doi: 10.1111/jdi.12370.
Yamada, K., Nakayama, H., Yoshinobu, S., Kawano, S., Tsuruta, M., Nohara, M., Hasuo, R., Akasu, S., Tokubuchi, I., Wada, N., Hirao, S., Iwata, S., Kaku, H., & Tajiri, Y. (2015). Effects of a sodium glucose co-transporter 2 selective inhibitor, ipragliflozin, on the diurnal profile of plasma glucose in patients with type 2 diabetes: A study using continuous glucose monitoring. Journal of diabetes investigation, 6(6), 699-707. https://doi.org/10.1111/jdi.12370
Yamada, Kentaro, et al. "Effects of a sodium glucose co-transporter 2 selective inhibitor, ipragliflozin, on the diurnal profile of plasma glucose in patients with type 2 diabetes: A study using continuous glucose monitoring." Journal of diabetes investigation vol. 6,6 (2015): 699-707. doi: https://doi.org/10.1111/jdi.12370
Yamada K, Nakayama H, Yoshinobu S, Kawano S, Tsuruta M, Nohara M, Hasuo R, Akasu S, Tokubuchi I, Wada N, Hirao S, Iwata S, Kaku H, Tajiri Y. Effects of a sodium glucose co-transporter 2 selective inhibitor, ipragliflozin, on the diurnal profile of plasma glucose in patients with type 2 diabetes: A study using continuous glucose monitoring. J Diabetes Investig. 2015 Nov;6(6):699-707. doi: 10.1111/jdi.12370. Epub 2015 Jun 20. PMID: 26543545; PMCID: PMC4627548.
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J Diabetes Investig. 2015 Nov;6(6):699-707. doi: 10.1111/jdi.12370. Epub 2015 Jun 20.

Effects of a sodium glucose co-transporter 2 selective inhibitor, ipragliflozin, on the diurnal profile of plasma glucose in patients with type 2 diabetes: A study using continuous glucose monitoring.

Journal of diabetes investigation

Kentaro Yamada, Hitomi Nakayama, Satoko Yoshinobu, Seiko Kawano, Munehisa Tsuruta, Masayuki Nohara, Rika Hasuo, Shoko Akasu, Ichiro Tokubuchi, Nobuhiko Wada, Saori Hirao, Shinpei Iwata, Hiroo Kaku, Yuji Tajiri

Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, Kurume University School of Medicine Kurume, Japan.

PMID: 26543545 PMCID: PMC4627548 DOI: 10.1111/jdi.12370

Abstract

AIMS/INTRODUCTION: To assess the effects of sodium glucose co-transporter 2 inhibitor therapy on the pathophysiology of type 2 diabetes.

MATERIALS AND METHODS: We administered ipragliflozin to 21 inpatients with type 2 diabetes for 7 days, and analyzed the diurnal profiles of plasma glucose and 3-hydroxybutyrate. A total of 21 age-, sex- and body mass index-matched diabetic patients served as controls.

RESULTS: Continuous glucose monitoring showed that the 24-h glucose curve was shifted downward without hypoglycemia by the administration of ipragliflozin. The average glucose level was reduced from 182 ± 54 mg/dL to 141 ± 33 mg/dL (P < 0.0001). The magnitude of the reduction was highly correlated with the baseline average glucose level. Homeostasis model assessment of insulin resistance was decreased, and homeostasis model assessment of β-cell function was increased during the treatment. Urinary glucose excretion was correlated with the average glucose level both on day 0 and on day 7, although the regression line was steeper and shifted leftward on day 7. The ipragliflozin-treated patients lost more weight than the control patients (1.4 ± 0.5 vs 0.5 ± 0.6 kg, P < 0.0001). Plasma levels of 3-hydroxybutyrate were significantly increased with peaks before breakfast and before dinner. Patient age and bodyweight loss were negatively and positively correlated with the peak levels of 3-hydroxybutyrate on day 7, respectively.

CONCLUSIONS: The ipragliflozin treatment improved the 24-h glucose curve without causing hypoglycemia. The close correlation between the magnitude of glucose reduction and the baseline plasma glucose concentration suggests that the risk of hypoglycemia is likely low. It might be prudent to monitor ketone body levels in younger patients and in patients with rapid weight loss.

Keywords: 3-Hydroxybutyrate; Continuous glucose monitoring; Sodium glucose co-transporter inhibitor

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