The Effect of Tofogliflozin Treatment on Postprandial Glucose and Lipid Metabolism in Japanese Men With Type 2 Diabetes: A Pilot Study

Abstract

BackgroundPostprandial hyperglycemia and hyperlipidemia are highly related to the development of atherosclerosis. Sodium/glucose cotransporter-2 (SGLT2) inhibitors have attracted attention as a new class of anti-diabetic agents for the treatment of type 2 diabetes. We investigated the effect of tofogliflozin on postprandial glucose and lipid metabolism in Japanese male patients with type 2 diabetes.MethodsTen Japanese men with type 2 diabetes (average age 66.3 years) were orally administered tofogliflozin (20 mg per day) for 8 weeks followed by a subsequent 8 weeks of washout of the agent. At 0, 8 and 16 weeks, postprandial metabolic parameters were measured at 0, 60 and 120 min after cookie ingestion.ResultsThere were significant reductions in body weight and body mass index at 8 weeks. There was a reduction in HbA1c at 8 weeks, which returned to pretreatment levels at 16 weeks. Serum insulin levels did not change during the entire study period under either fasting or postprandial state. The area under the curve of plasma glucagon significantly increased at 8 weeks. There were no changes in lipid and lipoprotein levels either in fasting or postprandial state except for tendency toward reduction in postprandial triglycerides at 8 weeks and increase in HDL-C at 16 weeks.ConclusionsTofogliflozin treatment causes an improvement of postprandial glucose metabolism but not considerable postprandial lipid metabolism.

Long‐term safety and efficacy of the sodium–glucose cotransporter 2 inhibitor, tofogliflozin, added on glucagon‐like peptide‐1 receptor agonist in Japanese patients with type 2 diabetes mellitus: A 52‐week open‐label, multicenter, post‐marketing clinical study

“…The post-marketing surveillance study showed that 20 mg of tofogliflozin treatment caused an increase in HDL-C, but did not change LDL-C and TG 12 . The effects of tofogliflozin on plasma lipid might not be straightforward as Kakuda et al reported 27 , and furthermore, the addition of GLP-1 receptor agonist would have more complex effects on the outcomes of lipids. Further study is required to evaluate the mode of action of tofogliflozin in lipid metabolism.…”

“…The effects of tofogliflozin on plasma lipid might not be straightforward as Kakuda et al . reported, and furthermore, the addition of GLP‐1 receptor agonist would have more complex effects on the outcomes of lipids. Further study is required to evaluate the mode of action of tofogliflozin in lipid metabolism.…”

Effects of Six Kinds of Sodium-Glucose Cotransporter 2 Inhibitors on Metabolic Parameters, and Summarized Effect and Its Correlations With Baseline Data

“…A 12-week dapagliflozin treatment reduced serum uric acid in the study by List et al [ 12 ], which was not observed in our study. An 8-week tofogliflozin treatment (n = 10) tended to decrease postprandial TG and significantly decreased uric acid, and a 16-week tofogliflozin (n = 10) treatment significantly elevated HDL-C [ 13 ]. However, tofogliflozin did not affect liver function.…”

Sodium-Glucose Cotransporter 2 Inhibitors Reduce Prandial Insulin Doses in Type 2 Diabetic Patients Treated With the Intensive Insulin Therapy

“…In our study, the SGLT2i addition showed reduction of blood glucose (non-significant) before each meal, however, showed a reduction (P < 0.05 and P < 0.1) of insulin doses before breakfast, lunch and dinner, which suggests an improvement of postprandial hyperglycemia by SGLT2i. Kakuda et al reported that tofogliflozin (SGLT2i) treatment causes an improvement of postprandial glucose metabolism [ 23 ]. Nishimura et al also showed that SGLT2i reduced postprandial hyperglycemia by increasing postprandial urinary glucose excretion, by using continuous glucose monitoring system [ 24 ].…”