A long-term effect of ipragliflozin on adipose tissue mass reduction by ipragliflozin in Japanese patients with obese type2 diabetes (mean BMI 35.1 ± 1.1 kg/m 2 ) was investigated. 17 of 20 participants completed this study. Ipragliflozin was administered (50 mg/day) once daily for 12 months. At 0, 3, 6 and 12 months, visceral and subcutaneous adipose tissue area was determined by two different bioelectrical impedance methods, and blood samples for HbA1c, renal function, lipids and liver function obtained, and body weight and blood pressure recorded. The primary endpoint was decrease in body fat mass. Secondary endpoints included changes in body weight and the laboratory data. Visceral fat area (cm 2 , mean ± SD) at 0, 3, 6 and 12 months was 166.0 ± 49.7, 149.7 ± 46.1, 149.7 ± 42.4 and 148.5 ± 40.2, respectively: the value at 3 months was significantly lower than baseline (P=0.027). Subcutaneous fat at the corresponding time points was 359.3 ± 110.5, 316.6± 87.1, 326.8 ± 87.2 and 325.9 ± 90.4, respectively: the values at each post treatment period were significantly less than the baseline (P=0.003, 0.018 and 0.036 for the three points, respectively). Body weight was significantly reduced by 12 months (P=0.045). Serum alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transpeptidase levels decreased significantly. There was no significant correlation between serum hepatobiliary enzyme levels and γ-body weight or visceral fat. But γ-GTP was correlated with subcutaneous fat (Spearman's P=0.004). During 1 year-interval, ipragliflozin significantly reduced subcutaneous adipose tissue and serum hepatobiliary enzyme levels, and may be useful in patients with obese diabetes.

A simple method for measurement of body temperature indicated that HDL-cholesterol level was predominantly associated with thermic effects of food in diabetic patients, while other metabolic factors showed no such relations. HDL-cholesterol may affect the postprandial regulation of body temperature in diabetic patients.