A Prospective, Open-Label Short-Term Pilot Study on Modification of the Skin Hydration Status During Treatment With a Sodium-Glucose Cotransporter-2 Inhibitor

Abstract

Introduction: Various types of skin lesions with pruritus have been reported in participants of Asian clinical trials on sodium-glucose cotransporter-2 (SGLT2) inhibitors. The aim of this study was to determine whether the diuretic effect of a SGLT2 inhibitor could modify skin hydration status in patients with type 2 diabetes mellitus. Methods: A prospective, short-term, open-label, two-parallel-arm, pilot study was conducted. Eligible patients were assigned to either a SGLT2 inhibitor (50 mg ipragliflozin once daily) group or to a dipeptidyl peptidase-4 inhibitor (50 mg sitagliptin once daily) group (control). The biophysical characteristics of the skin were measured and blood chemistry tests were run in all participants 1 day prior to medication initiation (pre-treatment values) and 14 days thereafter (post-treatment values). Results: Fourteen patients were enrolled in the study, of whom eight were in the ipragliflozin group and six in the sitagliptin group. Compared to the pre-treatment values, the glycated hemoglobin (HbA1c) levels were slightly but significantly reduced in the ipragliflozin group (p = 0.02), but the changes in HbA1c from the pre-treatment to post-treatment time points did not significantly differ between the two treatment groups. Serum 3-hydroxy butyrate levels were significantly higher in the ipragliflozin group than in the sitagliptin group (p \ 0.02). Neither electrical capacitance nor electrical conductance of the stratum corneum (SC), parameters that reflect skin water content, was reduced by 14 days of ipragliflozin treatment; similarly, no changes in these parameters were found in the sitagliptin control group. There was also no difference in the changes in water barrier function of the SC between the two treatment groups. There was a significant linear correlation (p \ 0.01) in skin water content at pre-treatment and that 14 days after treatment with each drug, respectively. Conclusion: Ipragliflozin treatment for 14 days did not significantly affect the skin hydration status in patients with well-controlled type 2

Association between sodium–glucose co-transporter 2 inhibitors and risk of psoriasis in patients with diabetes mellitus: a nationwide population-based cohort study

“…First, as SGLT2i treatment, may alter the sodium and water content through diuresis, we hypothesize that it could lead to skin dehydration, xerosis, pruritus and skin inflammation 33,34 . However, recent studies have shown that SGLT2i treatment reduced only the cutaneous sodium content and not the hydration status 35,36 . In addition, another study by Maifeld et al .…”

“…33,34 However, recent studies have shown that SGLT2i treatment reduced only the cutaneous sodium content and not the hydration status. 35,36 In addition, another study by Maifeld et al found that the cutaneous sodium content was elevated in patients with psoriasis and could be a potential marker for disease severity. 37 Thus, reducing the cutaneous sodium level after SGLT2i treatment, may conversely indicate a beneficial role for SGLT2i therapies in psoriasis.…”