Switching from low‐dose thiazide diuretics to sodium–glucose cotransporter 2 inhibitor improves various metabolic parameters without affecting blood pressure in patients with type 2 diabetes and hypertension

Abstract

Aims/IntroductionSodium–glucose cotransporter 2 (SGLT2) inhibitors function to increase urinary glucose excretion and improve glycemic control in individuals with type 2 diabetes mellitus. SGLT2 inhibitors, as well as diuretics, increase urinary volume, which leads to the reduction of blood pressure. The aim of the present study was to compare the effects of SGLT2 inhibitor and thiazide diuretic on blood pressure, metabolic parameters and body mass composition.Materials and MethodsA total of 31 participants were enrolled in the present study. We switched from thiazide diuretics to an SGLT2 inhibitor, ipragliflozin, in participants with type 2 diabetes and hypertension whose blood pressure was controlled with thiazide diuretics. Three months after the switch, we evaluated the effects of such switching on blood pressure, various metabolic parameters and body mass composition.ResultsThere was no significant difference in blood pressure from baseline to 3 months later. However, glycated hemoglobin, fasting plasma glucose and uric acid were significantly decreased after the switch. Body mass index and visceral fat area were also significantly reduced after the switch. Furthermore, urinary albumin excretion was also significantly decreased after the switch.ConclusionsSwitching from thiazide diuretic to an SGLT2 inhibitor, ipragliflozin, markedly improved various metabolic parameters and body mass composition without affecting blood pressure in participants with type 2 diabetes and hypertension.

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

“…The effects of ipragliflozin were evident as early as 2 weeks after treatment onset and were sustained for up to 16 weeks, consistent with the results of previous studies. The beneficial effects of ipragliflozin on blood pressure, lipid levels and hepatic function observed in the present study are also consistent with previous findings.…”

Protective effects of the SGLT2 inhibitor luseogliflozin on pancreatic β‐cells in db/db mice: The earlier and longer, the better

“…SGLT2 inhibitors are drawing much attention in clinical medicine as well as in basic research . According to the EMPA‐REG OUTCOME and CANVAS studies, an SGLT2 inhibitor prevents the development and progression of, not only macro‐angiopathy, but also heart failure and albuminuria .…”

“…Recently, SGLT2 inhibitors have been drawing much attention . SGLT2 inhibitors function in an insulin‐independent manner and lower blood glucose levels by enhancing urinary glucose excretion.…”

Competing Effects of Renin Angiotensin System Blockade and Sodium-Glucose Cotransporter-2 Inhibitors on Erythropoietin Secretion in Diabetes

“…Second, more potent diuretics, such as thiazide and loop diuretics are not associated with sustained increase in hematocrit values despite decreasing body fluid volume. In fact, switching patients from thiazide diuretics to the SGLT-2 inhibitor ipragliflozin was accompanied by an [52]. Finally, diuretics of loop of Henle, distal tubule and collecting duct (furosemide, hydrochlorothiazide, and amiloride, respectively) do not seem to affect EPO production, whereas diuretics acting predominantly at the proximal tubular site, such as acetazolamide, significantly reduce the EPO production in response to hypoxia in mice [53].…”