Endocrine Abstracts

Background and Aim: SGLT2 inhibitors are relatively new class of medications in the management portfolio of type 2 diabetes (T2DM). Despite their late introduction, they have gained substantial up–gradation in the treatment algorithm as suggested by various international bodies. Remogliflozin is an SGLT2i licensed in India and several other countries for the management of T2DM. We studied the effect of Remogliflozin on serum uric acid (SUA) levels in subjects with type 2 diabetes.

Methodology: In this prospective trial subjects visiting a specialized diabetes centre in Eastern India with T2DM, but without any other documented chronic diabetic complication were invited to participate. Once consented, all of them were administered Remogliflozin 100 mg twice daily for 3 months in addition to their existing antidiabetic regimen. Individuals were instructed to maintain their diet unchanged throughout the study period. During the review visit at the end of the third month, 2 subjects were lost to follow up and 1 person discontinued therapy due to hypoglycemia. Data of 44 adults (32/12 Males/ Females) were considered for analysis.

Result: The mean age, weight and UA level of the sample were 49.4 ± 8.6 years, 67.28 ± 11.4 kg and 6.5 ± 2.3 mg/dl respectively. After 3 months the cohort showed a significant drop in the UA level and weight (1.05 ± 1.1 mg/dl and 1.99 ± 2.4 kg respectively). When arranged in declining order of SUA reduction, in the upper sries 10 out of 22 subjects (45.4%) had a SUA drop of ≥1 mg/dl, whereas only 31.8% (7 of 22) had similar SUA reduction in the lower series (P < 0.05). Mean SUA reductions in the upper and lower series were 1.13 ± 1.3 and 0.97 ± 1.0 respectively. Similarly mean weight loss in both the series were2.3 ± 2.1 kg and 1.7 ± 2.1 kg in order. A numerical drop in the level of SUA was noted in majority (95.5%) of the individuals. Overweight & obese subjects showed a greater SUA reduction when compared to those with normal BMI (P < 0.05). Out of 16 adults with hyperuricemia (SUA >7 mg/dl), 12 (75%) could achieve normal UA without additional agents.

Conclusion: Remogliflozin reduced serum uric acid significantly, which was more prominent in overweight and obese individuals. This could be helpful while managing patients with type 2 diabetes and hyperurecemia with/ without obesity.