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Sodium Glucose Co-Transporter 2 Inhibition Does Not Favorably Modify the Physiological Responses to Dietary Counselling in Diabetes-Free, Sedentary Overweight and Obese Adult Humans

Authors
  • Ryan, Shane P.P.1
  • Newman, Alissa A.1
  • Wilburn, Jessie R.1
  • Rhoades, Lauren D.2
  • Trikha, S. Raj J.1, 2
  • Godwin, Ellen C.2
  • Schoenberg, Hayden M.1
  • Battson, Micah L.2
  • Ewell, Taylor R.1
  • Luckasen, Gary J.
  • Biela, Laurie M.1
  • Melby, Christopher L.2
  • Bell, Christopher1
  • 1 (L.M.B.)
  • 2 (C.L.M.)
Type
Published Article
Journal
Nutrients
Publisher
MDPI AG
Publication Date
Feb 18, 2020
Volume
12
Issue
2
Identifiers
DOI: 10.3390/nu12020510
PMID: 32085394
PMCID: PMC7071188
Source
PubMed Central
Keywords
License
Green

Abstract

Sedentary obesity is associated with increased risk of many cardio-metabolic diseases, including type 2 diabetes. Weight loss is therefore a desirable goal for sedentary adults with obesity. Weight loss is also a well-documented side effect of sodium glucose co-transporter 2 (SGLT2) inhibition, a pharmaceutical strategy for diabetes treatment. We hypothesized that, compared with placebo, SGLT2 inhibition as an adjunct to out-patient dietary counselling for weight loss would lead to more favorable modification of body mass and composition, and greater improvement in glucose regulation and lipid profile. Using a randomized, double-blind, repeated measures parallel design, 50 sedentary men and women (body mass index: 33.4 ± 4.7 kg/m2; mean ± SD) were assigned to 12 weeks of dietary counselling, supplemented with daily ingestion of either a placebo or SGLT2 inhibitor (dapagliflozin: up to 10 mg/day). Dietary counselling favorably modified body mass, body fat, glucose regulation, and fasting concentrations of triglyceride and very low-density lipoprotein cholesterol (main effects of counselling: p < 0.05); SGLT2 inhibition did not influence any of these adaptations (counselling × medication interactions: p > 0.05). However, SGLT2 inhibition when combined with dietary counselling led to greater loss of fat-free mass (counselling × medication interaction: p = 0.047) and attenuated the rise in high-density lipoprotein cholesterol (counselling × medication interaction: p = 0.028). In light of these data and the health implications of decreased fat-free mass, we recommend careful consideration before implementing SGLT2 inhibition as an adjunct to dietary counselling for weight loss in sedentary adults with obesity.

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