From the glucocentric model to new opportunitiesmetabolic control

Olga Iurova; Larisa Marchenkova

doi:10.1530/endoabs.63.P897

Objective: To study the parameters of carbohydrate and fat metabolism, electrolytes of urine against the background of taking SGLT-2 (i-SGLT-2) inhibitors in patients with type 2 diabetes mellitus with a GFR more than 60 ml/min

Materials and methods.: In the study, patients with newly diagnosed type 2 diabetes mellitus with excess weight and obesity (15 people) were prescribed drugs of group-i-SGLT-2 at the initial minimum dose. The level of HbA1c, the main anthropometric parameters were measured, the level of insulin, c-peptide, leptin, electrolytes of urine and of blood at the start and during the therapy 1-3-6 months after the start of treatment was assessed.

Results: In the examined group of patients, the dynamics of reduction of all the above parameters and their persistent preservation were noted, when there was no need to increase the dose of glyflozin group preparations to achieve the targets. Changes in blood electrolytes were not detected, but there was a persistent decrease in the excretion of sodium and chlorine.

Table 1
	0 start	1 month	3 months	6 months
Insulin basal, mcED/ml	10.7±0.6	5.3±0.7	4.5±0.5	4.0±0.5
Insulin stimulated, mcED/ml	21.0±0.5	9.8±0.8	7.1±0.7	6.8±0.5
C - peptide basal, ng/ml	2.6±0.5	1.9±0.2	1.8±0.2	1.7±0.3
C - peptide stimulated, ng/ml	5.5±0.6	4.5±0.4	4.3±0.3	4.1±0.2
Leptin, ng/ml	19.4±0.3	10.1±0.4	5.4±0.5	4.9±0.3
BMI, kg/m²	31.2±2.1	30.2±2.1	29.2±3.3	27.5±3.6
HbA1c, ℅	8.0±1.1	-	6.9±0.5	6.7±0.3
potassium of urine - (20.0–80.0) mM/l	72.19±2.4	78.5±1.8	60.34±2.1	58.3±2.0
sodium of urine - (30.0–261.0) mM/l Chloro of urine - (30.0–210.0) mM/l	36.0±2.01 153.0±5.6	35.9±1.87 40.2±2.4	13.6±1.9 41.3±2.8	12.3±2.0 39.5±2.5

Conclusion: The appointment of i-SGLT-2 as a monotherapy in the debut of type 2 diabetes mellitus allows not only to achieve long-term glycemic control, but indirectly affecting lipid and carbohydrate metabolism, leads to the elimination of metabolic disorders through the formation of a prolonged pharmacokinetic profile in the absence of polypharmacy and disturbances of electrolyte exchange. The persistent tendency to hyponatria and hypochloruria should be discussed.

Endocrine Abstracts

P897