Neutrophil to Lymphocyte ratio is significantly reduced after Sodium glucose cotransporter-2 inhibitor treatment in patients with type 2 diabetes mellitus

Abstract

Background. Sodium glucose cotransporter-2 inhibitors (SGLT2i) are novel therapeutic agents that became available in the treatment of type 2 diabetes mellitus (T2DM). This group of antidiabetic agents are associated with reduced glycated hemoglobin (HbA1c), fasting glucose, body weight and body mass index (BMI) in diabetic patients. All those beneficial effects may also be associated with a reduction in inflammatory burden. The purpose of the study is to compare neutrophil to lymphocyte ratio (NLR), a novel inflammatory marker derived from hemogram, before and 6 months after SGLT2i treatment in diabetic subjects. We also aimed to compare fasting glucose, HbA1c and other metabolic parameters as well as anthropometric measures (weight, BMI) before and 6 month after initiation of SGLT2i therapy. Materials and methods. The subjects with type T2DM that show up in internal medicine outpatient clinics of Abant Izzet Baysal University Hospital between January 2021 and December 2021 were enrolled to the study. Pretreatment and posttreatment NLR and other parameters were compared. We also obtained pretreatment and posttreatment laboratory data including urea, creatinine, fasting glucose, HbA1c, glomerular filtration rate, aspartate and alanine transaminases, plasma sodium and potassium. Results. Fasting glucose was reduced from 195±72 mg/dl in pretreatment period to 146±53 mg/dl in posttreatment period (p<0.001). HbA1c was reduced from 9.1±1.7% in pretreatment period to 7.7±1.7% in posttreatment period (p<0.001). The NLR before treatment was 2.6±1.2% before SGLT2i treatment and was reduced to 2.2±0.6% in 6th month of SGLT2i therapy. NLR was significantly decreased after treatment (p=0.003). Conclusions. We suggest that NLR levels could be a marker of reduced inflammatory burden in T2DM subjects receiving SGLT2i treatment.