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Effect of canagliflozin on circulating active GLP-1 levels in patients with type 2 diabetes: a randomized trial

Kohzo Takebayashi1, Kenji Hara1, Tomoko Terasawa1

  • 1Department of Internal Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan.

Endocrine Journal
|August 22, 2017
PubMed

Insights

Canagliflozin treatment in type 2 diabetes patients significantly reduced plasma glucose and insulin levels. It also increased active glucagon-like peptide 1 (GLP-1), a key hormone for glucose regulation, without affecting glucose-dependent insulinotropic peptide (GIP).

Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Type 2 diabetes is a metabolic disorder characterized by hyperglycemia.
  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors, like canagliflozin, are used to manage type 2 diabetes.
  • The incretin system, including glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), plays a crucial role in glucose homeostasis.

Purpose of the Study:

  • To investigate the effect of canagliflozin on circulating active glucagon-like peptide 1 (GLP-1) levels in patients with type 2 diabetes.
  • To assess the impact of canagliflozin on plasma glucose, serum insulin, and other incretin hormones.

Main Methods:

  • A randomized controlled study involving 30 patients with type 2 diabetes.
  • Patients received either a control treatment or 100 mg/day canagliflozin.
  • Both groups received 20 mg/day teneligliptin for the final 3 days of the study.
  • Meal tolerance tests were conducted to measure plasma glucose, serum insulin, active GLP-1, and active GIP levels.

Main Results:

  • Canagliflozin significantly decreased the area under the curve (AUC) for plasma glucose and serum insulin after 3 days.
  • Co-administration with teneligliptin further reduced plasma glucose but elevated serum insulin.
  • Canagliflozin significantly increased the AUC for plasma active GLP-1, with a further increase upon addition of teneligliptin.
  • Plasma active GIP levels were not significantly affected by canagliflozin treatment.

Conclusions:

  • Canagliflozin administration before meals effectively lowers plasma glucose and serum insulin levels in type 2 diabetes patients.
  • Canagliflozin enhances active GLP-1 levels, suggesting a potential mechanism for its glucose-lowering effects.
  • Canagliflozin does not significantly impact active GIP levels in this patient population.
Keywords:
CanagliflozinGIPGLP-1SGLT1

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