Abstract
Purpose
Our aim was to investigate the effects of the sodium glucose cotransporter 2 inhibitor
empagliflozin on urinary and serum glucose and electrolytes, urinary volume, osmolality,
and the renin−angiotensin system in patients with type 2 diabetes.
Methods
In an open-label study, 22 patients receiving metformin (median age 56 years; range
40–65 years) received empagliflozin 25 mg once daily for 5 days. Food, fluid, and
sodium intake were standardized for 3 days before and during treatment.
Findings
Twenty patients completed treatment. After single and multiple doses of empagliflozin,
mean (SE) changes from baseline in 24-hour urinary glucose excretion were 463.3 (57.3)
mmol/d and 599.5 (60.0) mmol/d, respectively (83.5 [10.3] g/d and 108.0 [10.8] g/d,
respectively) (both P < 0.001), and in fasting serum glucose concentration were −1.8 (0.4) mmol/L and −1.1
(0.3) mmol/L, respectively (both P < 0.001). After a single dose, mean (SE) change from baseline in urine sodium excretion
was 45.3 (9.6) mmol/d (P < 0.001), and in urine volume was 341.0 (140.5) g/d (P = 0.025), but there were no changes compared with baseline in either parameter after
multiple doses. There were no changes in plasma renin or serum aldosterone with single
or multiple doses of empagliflozin. There was a nonsignificant reduction in weight
after a single dose of empagliflozin and a mean (SE) change of −1.4 (0.5) kg after multiple doses (P = 0.020).
Implications
Empagliflozin 25 mg increased urinary glucose excretion and decreased serum glucose
and weight with transient natriuresis and increases in urine volume, without significant
changes in the renin−angiotensin system. Clinicaltrials.gov Identifier: NCT01276288.
Key words
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Article info
Publication history
Published online: September 28, 2016
Accepted:
September 7,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
