The objective of this study is to investigate the link between the
baseline/changes of body weight and those of diabetic parameters during
treatment with an SGLT-2 inhibitor. Drug naïve subjects with T2DM
received canagliflozin monotherapy for 3 months. Adipo-IR was selected as the
significant factor responsible for the changes of (Δ)BMI with this drug.
While no correlations were noted between ΔBMI and ΔFBG,
ΔHbA1c, ΔHOMA-R or ΔQUICKI, significant negative
correlations were observed between ΔBMI and Δadipo-IR
(R=−0.308). The subjects were divided into two groups with
baseline BMI<25 (n=31, group alpha) or≥25 (n=39,
group beta). Baseline levels of FBG, HbA1c, T-C, TG, non-HDL-C, LDL-C showed no
differences between group alpha and beta. The subjects were also divided into
two equal numbers of subjects (n=35 each) based on the changes of
weight: the lower half (−3.6%, p<0.00001, group A) and
the upper half (0.1%, n.s., group B) of ∆BMI. FBG, HbA1c or
HOMA-R significantly, similarly decreased, while QUICKI increased in group A and
B. TG significantly decreased, while HDL-C increased in group A. HOMA-B
significantly increased, while adipo-IR insignificantly decreased in group B.
Collectively, these results suggest that 1) adipose tissue insulin resistance is
responsible for the weight changes with canagliflozin. 2) baseline levels of
glycemic and some lipid parameters were similar between obese and non-obese
populations. 3) weight changes with canagliflozin were not associated with its
glycemic or insulin sensitizing efficacies but were linked to adipose-tissue
insulin resistance, some lipids, and beta-cell function.