798-P: Luseogliflozin Suppresses Fine Glycemic Fluctuation Late at Night: New Aspect of SGLT2 Inhibitor

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors block reabsorption of glucose by inhibiting SGLT2 in kidney, promotes the renal excretion of glucose. They have been proven to have a good glucose-lowering effect. To evaluating the effect of SGLT2 inhibitor on fine glycemic variability in type 2 diabetes mellitus (T2D) was used a continuous glucose monitoring system (CGMS) Freestyle Libre. The coefficient of variation (CV) of glucose levels every 15 minutes in the midnight zone (11pm-3am), which is less associated with diet and stress, was measured just before and just after the first administration of the SGLT2 inhibitor. Luseogliflozin (2.5mg per day) was administered to 6 patients with T2D. In Addition, fasting plasma glucose, postprandial plasma glucose, C-peptide, other hormones and metabolites were assessed. Luseogliflozin strongly suppressed CV of glucose (11.6±4.8 to 4.1±2.5, p=0.0012) (Figure). SGLT2 inhibitor suppressed fine glycemic fluctuations. There was no correlation with other factors. This inhibitory effect did not appear with sulfonylurea or DPP-4 inhibitors. (data not shown) Although the result is a new aspect of SGLT2 inhibitor, the clinical significance is not clear. Since Risso A et al reported that glycemic fluctuation cause harm to vascular endothelial cells (AJP 2001), SGLT2 inhibitors may reduce damage of blood vessel via regulation of fine glycemic fluctuation.View largeDownload slideView largeDownload slide DisclosureK. Yamauchi: None.