Yokomizo Hisashi, Kawanami Daiji, Sonoda Noriyuki, Ono Yasuhiro, Maeda Yasutaka, Itoh Jun, Tohyama Takeshi, Hirose Masayuki, Watanabe Hiroko, Kishimoto Junji, Ogawa Yoshihiro, Inoguchi Toyoshi
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan.
Department of Endocrinology and Diabetes, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180 Japan.
Diabetol Int. 2025 Jan 24;16(2):303-315. doi: 10.1007/s13340-025-00794-1. eCollection 2025 Apr.
Sodium glucose cotransporter-2 (SGLT2) inhibitors improve glycemic control and reduce body weight (BW) in individuals with type 2 diabetes. However, there are still concerns that compensatory hyperphagia may affect their effects. Here, we performed an exploratory prospective study to investigate whether dietary intake and/or eating behaviors affect glycemic control and BW under long-term treatment with dapagliflozin. Fifty-three Japanese individuals with type 2 diabetes received dapagliflozin 5 mg daily for 104 weeks, with frequent assessments of HbA1c, BW, body composition, dietary intake, and eating behaviors. Dietary intake was evaluated using a brief self-administered diet history questionnaire, and eating behavior was evaluated using the Dutch Eating Behavior Questionnaire. The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000019192). At 104 weeks, HbA1c decreased by 0.5% and BW decreased by 2.8 kg (both < 0.001), with a dominant decrease in body fat mass by 2.2 kg ( < 0.001). No significant change was observed in calorie intake or the proportion of carbohydrates, protein, and fat. The change (∆) in HbA1c was significantly correlated with basal HbA1c, basal triglyceride levels, ∆BMI (body mass index), ∆BFP (body fat percentage), and ∆ferritin levels. The ∆BMI was significantly correlated with only the ∆BFP. Neither the ∆HbA1c nor ∆BMI was significantly correlated with dietary intake, any type of eating behavior, or changes in these parameters during this study. In conclusion, dapagliflozin treatment improved glycemic control and reduced BW without being affected by any changes in dietary intake or eating behavior over 104 weeks.
The online version contains supplementary material available at 10.1007/s13340-025-00794-1.
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂可改善2型糖尿病患者的血糖控制并减轻体重（BW）。然而，人们仍担心代偿性多食可能会影响其疗效。在此，我们进行了一项探索性前瞻性研究，以调查在长期使用达格列净治疗期间，饮食摄入和/或饮食行为是否会影响血糖控制和体重。53名日本2型糖尿病患者每天服用5毫克达格列净，持续104周，期间频繁评估糖化血红蛋白（HbA1c）、体重、身体成分、饮食摄入和饮食行为。饮食摄入通过一份简短的自我管理饮食史问卷进行评估，饮食行为通过荷兰饮食行为问卷进行评估。该研究已在大学医院医学信息网络临床试验注册中心（UMIN000019192）注册。在104周时，HbA1c下降了0.5%，体重下降了2.8千克（均P＜0.001），其中体脂肪量显著下降了2.2千克（P＜0.001）。热量摄入以及碳水化合物、蛋白质和脂肪的比例均未观察到显著变化。HbA1c的变化（∆）与基础HbA1c、基础甘油三酯水平、∆体重指数（BMI）、∆体脂百分比（BFP）和∆铁蛋白水平显著相关。∆BMI仅与∆BFP显著相关。在本研究期间，∆HbA1c和∆BMI均与饮食摄入、任何类型的饮食行为或这些参数的变化无显著相关性。总之，达格列净治疗可改善血糖控制并减轻体重，在104周内不受饮食摄入或饮食行为任何变化的影响。
在线版本包含可在10.1007/s13340-025-00794-1获取的补充材料。
