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. 2024 Dec 16;24(1):4.
doi: 10.1007/s40200-024-01508-1. eCollection 2025 Jun.

Effect of dapagliflozin on the serum metabolome in patients with type 2 diabetes mellitus

Sempastian Filippas-Ntekouan  1 , Aikaterini Dimou  2 , Panagiotis Dafopoulos  2 , Christina Kostara  2 , Eleni Bairaktari  2 , Styliani Chasapi  3 , Georgios Spyroulias  3 , Theoharis Koufakis  4 , Anastasios Koutsovasilis  5 , Vasileios Tsimihodimos  1
Affiliations

Effect of dapagliflozin on the serum metabolome in patients with type 2 diabetes mellitus

Sempastian Filippas-Ntekouan et al. J Diabetes Metab Disord. .

Abstract

Objectives: SGLT-2 inhibitors have been shown to exert cardio- and renoprotective actions. We aimed to investigate the underlying mechanisms using 1H-NMR based metabolomics in patients with type-2 diabetes mellitus who received dapagliflozin.

Methods: 50 patients with type 2 diabetes mellitus, inadequately controlled on metformin monotherapy (HbA1c > 7%) received dapagliflozin for 3 months and 30 matched patients received insulin degludec for 3 months. Clinical and laboratory values, as well as 1H-NMR based metabolomics were assessed before treatment and after completion of 3 months of treatment.

Results: Dapagliflozin reduced weight, body mass index, systolic and diastolic blood pressure significantly. Using 1H-NMR based metabolomics, the dapagliflozin group showed a good separation with a degree of overlap before and after treatment initiation. Regarding targeted metabolomics, dapagliflozin increased serum ketone, citrate and tryptophan levels compared with insulin. On the other hand, serum taurine, threonine and mannose levels were significantly decreased following dapagliflozin administration.

Conclusions: Dapagliflozin led to a small, but significant change in serum metabolome. The observed changes may indicate improvement in energy metabolism, reduction in inflammatory activity and decreased insulin resistance which may provide further evidence of the agent's observed cardiac and renal protection. The study was registered with ClinicalTrials.gov (identifier: NCT02798757).

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-024-01508-1.

Keywords: Dapagliflozin; Insulin; Metabolomics; SGLT-2.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

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