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薬理と治療
Abstract
Objectives It is extremely important to prevent the development and exacerbation of atherosclerotic cardiovascular disease and diabetic complications, especially nephropathy, in patients with diabetes mellitus(DM). Recently, sodium-glucose cotransporter 2(SGLT2)inhibitors have been reported to reduce cardiovascular death in DM patients by 38% and have protective effects for several organs, such as heart and kidney. In this study, we examined the effectiveness of tofogliflozin on the clinical parameters in type 2 DM patients with obesity. Methods Subjects were recruited for the condition: body mass index 25 or higher, HbA1c over 8%, serum creatinine under 2 mg/dL, and have not previously taken SGLT2 inhibitors. For 18 type 2 DM patients with obesity, tofogliflozin was administered at 20 mg╱day for 1 year, and clinical parameters including body weight, blood pressures, postprandial plasma glucose(PPG), HbA1c, blood cells, liver and renal functions, lipids, urinalysis, urinary microalbumin(urine Alb), urinary NAG, urinary β2-MG, urinary L-FABP, and plasma BNP were measured every 2 months. During the period, adverse events were also investigated, and the usage and dose of antihypertensive and antilipid drugs and DM treatments were not changed. Results Tofoglifrozin significantly decreased the levels of PPG and HbA1c after 2 months, systolic blood pressure after 12 month, GOT after 6 months, GPT after 10 months, urinary Alb after 8 month, and urinary β2-MG after 6 months. Although body weight, pulse rate, blood cells, lipids, renal function, and plasma BNP did not change, urinary NAG and L-FABP showed tendency to decrease after 2 months. During the period, there were no adverse events such as hypoglycemia, urinary tract infections, or increased urinary ketones. Conclusion This study revealed that tofogliflozin is an effective and safe drug that has the effect of protecting liver and kidney dysfunctions in addition to improve glucose metabolism in type 2 DM patients with obesity.
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