Canagliflozin Increases Calorie Intake in Type 2 Diabetes Without Changing the Energy Ratio of the Three Macronutrients: CANA-K Study.

Abstract

Background: Sodium/glucose cotransporter-2 (SGLT2) inhibitors improve glycemic control and reduce body weight by increasing glycosuria. Although a compensatory increase of food intake has been reported, the long-term effect of SGLT2 inhibitors on food intake remains unclear. This study investigated the influence of canagliflozin on calorie and nutrient intake over 1 year. Materials and Methods: Patients with type 2 diabetes (n = 107) were enrolled and followed prospectively while receiving canagliflozin at 100 mg/day for 12 months. Intake of nutrients was investigated by using the food frequency questionnaire. Hemoglobin A1c, body weight, and satisfaction with diabetes treatment (assessed by the Diabetes Treatment Satisfaction Questionnaire: DTSQ) were also investigated. Results: The baseline total energy intake was 1723 ± 525 kcal/day and it showed a persistent increase during treatment with canagliflozin, being 132 kcal higher at 6 months (P = 0.0058) and 113 kcal higher at 12 months (P = 0.0516). Intake of all three macronutrients (carbohydrate, protein, and fat) was significantly increased after 6 months of canagliflozin treatment (P = 0.0129, P = 0.0160, and P = 0.0314, respectively), but their ratio was unchanged. The DTSQ score improved significantly and both hemoglobin A1c and body weight showed a significant decrease throughout treatment (all P < 0.0001). Conclusions: After patients with type 2 diabetes commenced canagliflozin, their calorie intake increased without changing the ratio of the three macronutrients. Despite elevation of the calorie intake, glycemic control improved and weight loss was achieved. Satisfaction with treatment of diabetes also increased.

• Authors: Ikuro Matsuba, Akira Kanamori, Masahiro Takihata, Masahiko Takai, Hajime Maeda, Akira Kubota, Kotaro Iemitsu, Shinichi Umezawa, Mitsuo Obana, Mizuki Kaneshiro, Takehiro Kawata, Tetsuo Takuma, Hiroshi Takeda, Hideo Machimura, Atsuko Mokubo, Tetsuya Motomiya, Taro Asakura, Taisuke Kikuchi, Yoko Matsuzawa, Shogo Ito, Masaaki Miyakawa, Yasuo Terauchi, Yasushi Tanaka
• Journal: Diabetes technology & therapeutics (Diabetes Technol Ther) Vol. 22 Issue 3 Pg. 228-234 (03 2020) ISSN: 1557-8593 [Electronic] United States
• PMID: 32013567 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Dietary Carbohydrates
• Dietary Fats
• Dietary Proteins
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Insulin
• Sodium-Glucose Transporter 2 Inhibitors
• Canagliflozin

Topics

• Aged
• Canagliflozin (pharmacology)
• Diabetes Mellitus, Type 2 (blood, drug therapy)
• Diet Surveys
• Dietary Carbohydrates (blood)
• Dietary Fats (blood)
• Dietary Proteins (blood)
• Energy Intake (drug effects)
• Energy Metabolism (drug effects)
• Female
• Glycated Hemoglobin (analysis)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insulin (therapeutic use)
• Male
• Middle Aged
• Nutrients (blood)
• Prospective Studies
• Sodium-Glucose Transporter 2 Inhibitors (pharmacology)
• Weight Loss (drug effects)