Dapagliflozin Add-On Therapy Improves Body Composition and Metabolic Parameters in Overweight Type 2 Diabetic Patients: A Pilot Study
Bibliographic record
Abstract
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) inhibit renal glucose reabsorption in the proximal tubules, and reduce plasma glucose, body weight and cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). The data on the effect of SGLT-2i on body composition are conflicting: in some reports, they reduce fat mass, while in other reports, they determine reduction of extra- and intra-cellular fluids. The aim of our pilot study was to investigate the body compartments changes and the effects on glycemia and plasma lipids of add-on SGLT2-i dapagliflozin therapy in poorly controlled overweight/obese T2DM patients. Methods: Fifty-six overweight (body mass index (BMI) > 25) uncontrolled (HbA1c > 53 mmol/mol; 7%) T2DM outpatients were recruited. They were treated with metformin and basal insulin (group A) or metformin (group B). Weight, BMI, waist circumference (WC), fasting blood glucose (FPG), HbA1c, plasma lipids, bioelectric parameters and derived body compartments (phase angle (pA), total body water (TBW), fat free mass (FFM) and fat mass (FM)) were assessed at baseline (T0) and after 16 weeks (T1) of dapagliflozin 10 mg add-on treatment. Student’s t -test and one-way analysis of variance (ANOVA) were used to compare the T0 and T1 data. Results: After 16 weeks, all the patients had weight loss (-3.0 ± 0.6 kg, P < 0.0001) and reduced WC (-2.5 ± 0.6 cm, P < 0.0001). Weight reduction was significant in both groups separately (group A: -2.5 ± 0.3 kg, P <= 0.001; group B: -3.4 ± 0.4 kg, P <= 0.001) and was higher in group B. FFM was not impaired in group A (from 60.2 ± 5.2 to 59.5 ± 8.1 kg; ns) and in group B (from 60.4 ± 6.2 to 59.3 ± 6.6 kg; ns). FM decreased in all the patients (29.9 ± 6.84 kg vs. 26.30 ± 7.4 kg, P < 0.000); a higher reduction was found in group B (-3.6 ± 1.2 kg, P < 0.001) vs. group A (-2.3 ± 1.3 kg, P < 0.001). Metabolic control improved in all the patients: FPG 172 ± 49.4 mg/dL vs. 137 ± 36.8 mg/dL at T1, P < 0.0001; HbA1c 69 ± 9.3 mmol/mol (8.5±1.5%) vs. 60 ± 8.7 mmol/mol (7.6±1.4%), P = 0.000. In group A, insulin dose was reduced by 9.3%. Cholesterol and triglycerides (TG) levels decreased in overall population (181.8 ± 48.8 mg/dL vs. 170.7 ± 40.7, P = 0.003; 172 ± 93 mg/dL vs. 143.2 ± 87.8, P = 0.000). Conclusions: Dapagliflozin add-on therapy induced weight loss and metabolic improvement in overweight and obese T2DM patients. Also insulin-treated patients had weight loss (2.5 kg). Bioelectric impedance analysis (BIA) demonstrated FM loss without FFM impairment and was confirmed to be a simple and effective method to assess body composition in clinical practice. J Endocrinol Metab. 2019;9(4):90-94 doi: https://doi.org/10.14740/jem564
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".