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SGLT2 inhibitors for genetic and acquired insulin resistance: Considerations for clinical use

Yusei Hosokawa1, Wataru Ogawa1

  • 1Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Journal of Diabetes Investigation
|May 30, 2020
PubMed

Insights

Sodium-glucose cotransporter 2 inhibitors lower glucose levels by increasing urinary glucose excretion. This can decrease the insulin needed for glucose disposal, potentially masking underlying insulin resistance.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Insulin resistance is a key factor in metabolic dysfunction.
  • Accurate assessment of insulin resistance is crucial for effective treatment.
  • Urinary glucose excretion is a potential target for glycemic control.

Purpose of the Study:

  • To investigate the effect of sodium-glucose cotransporter 2 inhibitors on glucose disposal.
  • To determine if these inhibitors can alter insulin requirements independent of improving insulin resistance.
  • To evaluate the impact on the assessment of insulin resistance.

Main Methods:

  • Administration of sodium-glucose cotransporter 2 inhibitors to individuals with insulin resistance.
  • Measurement of glucose disposal and insulin requirements.
  • Analysis of urinary glucose excretion levels.

Main Results:

  • Sodium-glucose cotransporter 2 inhibitors increased urinary glucose excretion.
  • This led to a reduced need for glucose disposal to maintain glycemia.
  • Insulin requirements decreased, irrespective of changes in intrinsic insulin sensitivity.

Conclusions:

  • Sodium-glucose cotransporter 2 inhibitors can lower glycemia through enhanced urinary glucose excretion.
  • The observed decrease in insulin requirement may not reflect an improvement in insulin resistance.
  • This highlights a potential confounder in the clinical evaluation of insulin resistance.

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