877-P: Effects of SGLT2 Inhibitors on Gut Microbiota in Japanese Patients with Type 2 Diabetes

Abstract

SGLT2 inhibitors (SGLT2is) promote urinary glucose excretion, thereby lowering blood glucose. In addition, SGLT2is have been reported to reduce body weight. However, the mechanism underlying the reduction in the body weight induced by SGLT2i remains to be elucidated. In this study, we investigated the effects of SGLT2is on the gut microbiota. A total of 36 Japanese patients with type 2 diabetes received SGLT2is for 3 months, and the prevalences of balance-regulating bacteria (12 types), which regulate the balance of the gut microbiota to maintain health, and balance-disturbing bacteria (6 types), which disturb the balance of the gut microbiota to cause disease, in the feces of the patients before and after 3 months of SGLT2i treatment were determined. Furthermore, the prevalences of short-chain fatty acid-producing bacteria (6 types), which are thought to be involved in body weight gain and weight loss, were also analyzed individually. The SGLT2i treatment was associated with a significant increase of the overall prevalence of the 12 types of balance-regulating bacteria. In addition, significant increases in the prevalences of the short-chain fatty acid-producing bacteria among the balance-regulating bacteria were also observed. However, the SGLT2i treatment had no effect on the balance-disturbing bacteria. Individual analyses of the balance-regulating bacteria revealed that the SGLT2i treatment was associated with a significant increase in the prevalence of Ruminococci, which are balance-regulating bacteria classified as short-chain fatty acid-producing bacteria. In conclusion, SGLT2i treatment was associated with an overall increase in the prevalence of balance-regulating bacteria. Among the balance-regulating bacteria, the prevalences of short-chain fatty acid-producing bacteria increased. Since short-chain fatty acids have been reported to prevent obesity, these results suggest that SGLT2is might induce body weight reduction via their actions on the gut microbiota. Disclosure M.Kusunoki: Research Support; Taisho Pharmaceutical Holdings Co., Ltd., Ono Pharmaceutical Co., Ltd., Daiichi Sankyo, Kaken Pharmaceutical Co., Ltd., Eli Lilly Japan K.K. F.Hisano: None. S.Matsuda: None. T.Miyata: None.