Switching from low‐dose thiazide diuretics to sodium–glucose cotransporter 2 inhibitor improves various metabolic parameters without affecting blood pressure in patients with type 2 diabetes and hypertension

• Published in: Journal of diabetes investigation Vol. 9; no. 4; pp. 875 - 881
• Main Authors: Kimura, Tomohiko, Sanada, Junpei, Shimoda, Masashi, Hirukawa, Hidenori, Fushimi, Yoshiro, Nishioka, Momoyo, Kinoshita, Tomoe, Okauchi, Seizo, Obata, Atsushi, Kohara, Kenji, Tatsumi, Fuminori, Kamei, Shinji, Nakanishi, Shuhei, Mune, Tomoatsu, Kaku, Kohei, Kaneto, Hideaki
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.07.2018; John Wiley and Sons Inc
• Subjects: Aged; Blood pressure; Blood Pressure - drug effects; Body mass index; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diuretics; Excretion; Female; Glucose; Glucosides - therapeutic use; Hemoglobin; Humans; Hypertension; Hypertension - complications; Hypertension - drug therapy; Hypertension - metabolism; Hypoglycemic Agents - therapeutic use; Male; Metabolism; Middle Aged; Na+/glucose cotransporter; Original; Sodium; Sodium Chloride Symporter Inhibitors - therapeutic use; Sodium-Glucose Transporter 2; Sodium-Glucose Transporter 2 Inhibitors; Sodium–glucose cotransporter inhibitor; Thiazide diuretics; Thiophenes - therapeutic use; Treatment Outcome; Uric acid; Japan; Hypertension; Sodium-glucose cotransporter inhibitor; Thiazide diuretics
• ISSN: 2040-1116; 2040-1124; 2040-1124
• DOI: 10.1111/jdi.12774

Aims/Introduction Sodium–glucose cotransporter 2 (SGLT2) inhibitors function to increase urinary glucose excretion and improve glycemic control in individuals with type 2 diabetes mellitus. SGLT2 inhibitors, as well as diuretics, increase urinary volume, which leads to the reduction of blood pressure. The aim of the present study was to compare the effects of SGLT2 inhibitor and thiazide diuretic on blood pressure, metabolic parameters and body mass composition. Materials and Methods A total of 31 participants were enrolled in the present study. We switched from thiazide diuretics to an SGLT2 inhibitor, ipragliflozin, in participants with type 2 diabetes and hypertension whose blood pressure was controlled with thiazide diuretics. Three months after the switch, we evaluated the effects of such switching on blood pressure, various metabolic parameters and body mass composition. Results There was no significant difference in blood pressure from baseline to 3 months later. However, glycated hemoglobin, fasting plasma glucose and uric acid were significantly decreased after the switch. Body mass index and visceral fat area were also significantly reduced after the switch. Furthermore, urinary albumin excretion was also significantly decreased after the switch. Conclusions Switching from thiazide diuretic to an SGLT2 inhibitor, ipragliflozin, markedly improved various metabolic parameters and body mass composition without affecting blood pressure in participants with type 2 diabetes and hypertension. Switching from thiazide diuretic to an SGLT2 inhibitor ipragliflozin markedly improved various metabolic parameters and body mass composition without affecting blood pressure in subjects with type 2 diabetes and hypertension.