Effects of ipragliflozin on glycemic control, appetite and its related hormones: a prospective, multicenter, open-label study (SOAR-KOBE Study).

AIMS: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors improve blood glucose control as well as reduce body weight by promoting urinary glucose excretion. The weight loss is less than expected from urinary glucose loss, however, likely because of an increase in food intake. To investigate whether SGLT-2 inhibitors might increase appetite by affecting related hormones, we examined the effects of the SGLT-2 inhibitor ipragliflozin, including those on appetite-regulating hormones, in individuals with suboptimally controlled type 2 diabetes.

MATERIALS AND METHODS: This prospective, multicenter, open label study was performed with 96 patients with a body mass index of ≥22 kg/m2 who were treated with ipragliflozin (50 mg/day) for 16 weeks. Parameters including glycated hemoglobin (HbA1c ) level, body weight, circulating leptin and active ghrelin concentrations, and appetite as assessed with a visual analog scale (VAS) were measured before and during treatment.

RESULTS: Both HbA1c level (from 7.9 ± 0.8 to 7.1 ± 0.7%) and body weight (from 75.2 ± 12.6 to 72.6 ± 12.4 kg) were significantly decreased after treatment for 16 weeks. The fasting serum leptin level was significantly decreased after 2 weeks (from 19.5 ± 13.1 to 18.1 ± 12.4 ng/mL) and remained decreased up to 16 weeks, even after adjustment for body weight, while the plasma active ghrelin level showed no significant change. The VAS score for hunger was significantly increased at 2 and 8 weeks.

CONCLUSIONS: Our results suggest that ipragliflozin improved glycemic control and reduced body weight, but also reduced serum leptin levels and may thereby have increased appetite. This article is protected by copyright. All rights reserved.