The effect of the sodium-glucose cotransporter-2 inhibitors in combination with metformin on various metabolic health parameters of patients with type 2 diabetes and visceral obesity

• Alexander S. Ametov
• Zhigareva Anna V.
• Evgeniya Yu. Pashkova
• Khaider Kh. Sharafetdinov

Abstract

The aim - to assess the effect of canagliflozin and metformin therapy on carbohydrate and fat metabolism in patients with type 2 diabetes and visceral obesity.

Material and methods. The study 35 patients with type 2 diabetes and visceral obesity with poor glycemic control. Before inclusion in the study, patients received various oral hypoglycemic therapy: 12 patients received monotherapy of metformin, 4 patients - monotherapy of sulfonylurea, 5 patients received combination therapy of metformin and sulfonylurea, 6 patients received combination therapy of metformin and DPP-4 inhibitors. And 8 patients with new-onset type 2 diabetes. Patients got laboratory and instrumental methods of research. It is prescribed a hypoglycemic therapy with the sodium-glucose linked transporter-2 - canagliflozin in a dose of 100 or 300 mg. The duration of treatment and observation of patients was 6 months, after which a follow-up examination was performed.

Results and discussion. Against the background of combined therapy with canagliflozin and metformin, the main indicators of carbohydrate metabolism are as close as possible to physiological parameters. At the same time, a significant decrease in body weight, a decrease in waist circumference, as well as normalization of the most important indicators of metabolic health were noted. We obtained a decrease in BMI, weight, waist circumference and leptin level against the background of an inversely proportional increase in the level of high molecular weight adiponectin - a key marker of metabolic health. In turn, an increase in adiponectin levels was accompanied by a significant decrease in visceral fat area and an improvement in insulin sensitivity, as measured by the HOMA index

Conclusion. Therapy of the sodium-glucose linked transporter-2 inhibitors canagliflozin in combination with metformin allows to achieve the basic goals of diabetes treatment, such as glycemic control parameters and weight loss, as well as normalize the balance between key adipokines, positively affecting metabolic health.

Keywords:type 2 diabetes, leptin, adiponectin, canagliflozin, visceral obesity, markers of metabolic health

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