Related Experiment Video
Updated: Sep 13, 2025

Determining Glucose Metabolism Kinetics Using 18F-FDG Micro-PET/CT
Published on: May 2, 2017
SGLT2 Inhibitor Treatment Is Associated With Reduced Cardiac Glucose Metabolism: A Matched FDG-PET Cohort Study
Brett W Sperry1, Yazan Almohtasib1, Ramy Ghaly1
1Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City, Kansas City, Missouri, USA.
Background:
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have cardioprotective effects without acting directly on the myocardium.
Objectives:
The purpose of the study was to evaluate the impact of SGLT2i on myocardial glucose utilization.
Methods:
This retrospective propensity-matched cohort study examined subjects who underwent whole-body 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography for oncologic purposes between 2016 and 2024. A 1:1 propensity match analyzed positron emission tomography-derived myocardial FDG uptake, maximum myocardial standardized uptake value (SUV), and total myocardial glycolysis in SGLT2i-treated vs untreated patients.
Results:
Among 6,747 subjects, 187 were actively prescribed SGLT2i and matched with 187 who were not. Mean age was 68.4 ± 9.7 years, 57.5% were males, 81.8% had diabetes, and 41.4% had heart failure. Myocardial FDG uptake (to quantify glucose utilization) was absent in 64.7% of patients on SGLT2i and 37.4% not on SGLT2i (P < 0.001), despite higher prescan glucose in those receiving SGLT2i (124 vs 110 mg/dL). SUVmax (5.4 vs 5.8, P = 0.004), volume of myocardial FDG uptake (0.8 cm3 vs 4.6 cm3, P = 0.001), and total myocardial glycolysis (1.6 g vs 20.6 g, P < 0.001) were significantly lower in patients treated with SGLT2i vs those untreated. SGLT2i use blunted insulin-induced increases in total myocardial glycolysis (P-interaction 0.036). There was no difference in background SUVmax and SUVmean in the blood pool and liver.
Conclusions:
SGLT2i use was associated with a greater suppression of myocardial glucose without affecting background tissue glycolysis despite higher prescan glucose levels. These findings add to the understanding of the effect of SGLT2i on the myocardium and may have implications with respect to cardiac imaging protocols that require glucose manipulation.
More Related Videos
06:51Utilizing 18F-FDG PET/CT Imaging and Quantitative Histology to Measure Dynamic Changes in the Glucose Metabolism in Mouse Models of Lung Cancer
Published on: July 21, 2018
10:35Extracellular Glucose Depletion as an Indirect Measure of Glucose Uptake in Cells and Tissues Ex Vivo
Published on: April 6, 2022
Related Concept Videos
Dipeptidyl Peptidase 4 Inhibitors
Oral Hypoglycemic Agents: Biguanides and Glitazones
Glucose Transporters
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
Oral Hypoglycemic Agents: Glinides
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
Acarbose and miglitol are...