Background: Previous reports on animal studies suggest that SGLT2 inhibitors (SGLT2i) affect appetite and food intake. However, in humans, the relationship between SGLT2i and changes in the intake of foods and nutrients is not clear. Therefore, we investigated the relationship between the effect of SGLT2 inhibitors and dietary intake in Japanese patients with type 2 diabetes using a self-administered dietary history questionnaire (DHQ).

Methods: We performed a non-controlled, open-label study, wherein 51 patients with type 2 diabetes were enrolled from Niigata University and 3 related hospitals between December 2017 and August 2018 (registered at UMIN-CTR as UMIN000023902). They were newly administered empagliflozin, and their dietary habits were examined using the DHQ at the beginning and after six months. We evaluated the relationship between HbA1c and body mass index (BMI) with changes in the intake of foods and nutrients.

Results: Forty-nine subjects completed the study (30 males, 62.6 ± 11.0 years old). After 6 months from the start, HbA1c showed a significant improvement from 7.6 ± 1.2 to 7.1 ± 1.0% (p < 0.001), and the BMI decreased from 27.9 ± 5.1 to 26.9 ± 5.2 kg/m2 (p < 0.001). The carbohydrate energy ratio increased from 58.1 ± 8.3% to 60.4 ± 8.3% (p = 0.04) and the protein energy ratio decreased from 14.7 ± 2.4% to 13.5 ± 2.3% (p < 0.001). Regarding intake by food group, the consumption of fruits increased from 87.5 ± 69.1 g to 146.7 ± 204.7 g (p = 0.04), the intake of confectionaries increased from 53.0 ± 43.4 g to 69.3 ± 59.4 g (p = 0.02), and that of fish and shellfish decreased from 83.2 ± 54.7 g to 68.0 ± 36.8 g (p = 0.02). In addition, the reduction in HbA1c was associated with the reduction in BMI, and reduction in BMI was associated with the reduction in the sugar intake.

Conclusions: The results suggested that intake of foods and nutrients was changed before and after the initiation of SGLT2i, and that this change could affect the blood glucose levels and BMI.

Disclosure

H. Kabasawa: Research Support; Self; Astellas Pharma Inc., Biotec Japan Corporation, Daiichi Sankyo Company, Limited, Forica Foods CO.,LTD., KAMEDA SEIKA CO., LTD., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K, Novo Nordisc Pharma Ltd, Sato Foods Industries CO.,LTD., Taisho Toyama Pharmaceutical.CO.,LTD., Takeda Pharmaceutical Company Limited. M. Hosojima: Research Support; Self; Astellas Pharma Inc., Biotech Japan Corporation, Daiichi Sankyo Co.,Ltd., Eli Lilly Japan K.K., Forica Foods Co.,Ltd., Kameda Seika Co.,Ltd., Kyowa Hakko Kirin Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novo Nordisc Pharma Ltd., Sato Foods Industries Co.,Ltd., Taisho Toyama Pharmaceutical.Co.,Ltd., Takeda Pharmaceutical Co.,Ltd. T. murayama: None. T. Tanaka: None. S. Kuwahara: None. R. Kaseda: None. Y. Suzuki: None. I. Narita: None. A. Saito: None.

Funding

Japan Agency for Medical Research and Development

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.