Skip to main content
Log in

Effects of the combination of SGLT2 selective inhibitor ipragliflozin and various antidiabetic drugs in type 2 diabetic mice

  • Research Article
  • Published:
Archives of Pharmacal Research Aims and scope Submit manuscript

Abstract

The sodium-glucose cotransporter 2 (SGLT2) is responsible for most glucose reabsorption in the kidney and has been proposed as a novel therapeutic target for the treatment of type 2 diabetes. In the present study, the combinatory effects of SGLT2 selective inhibitor ipragliflozin and various antidiabetic drugs in high-fat diet and streptozotocin-nicotinamide-induced type 2 diabetic mice were investigated. Ipragliflozin dose-dependently increased urinary glucose excretion and improved glucose tolerance. In addition, each antidiabetic drug (mitiglinide, glibenclamide, sitagliptin, insulin, metformin, voglibose, or rosiglitazone) also significantly improved glucose tolerance without affecting urinary glucose excretion. Combination treatment of ipragliflozin with each antidiabetic drug additively improved glucose tolerance. In these experiments, ipragliflozin-induced increases in urinary glucose excretion were not influenced by combination treatment with antidiabetic drugs. Further, ipragliflozin did not affect antidiabetic drug-induced insulinotropic action (mitiglinide and glibenclamide), increases in plasma glucagon-like peptide-1 and insulin levels via inhibition of dipeptidyl peptidase 4 activity (sitagliptin), increases in plasma insulin level (insulin), decreases in hepatic phosphoenolpyruvate carboxykinase activity (metformin), inhibition of small intestinal disaccharidase activity (voglibose), or improvement of impaired insulin secretion (rosiglitazone). These results suggest that combination treatment of ipragliflozin with various antidiabetic drugs additively enhances the improvement in glucose tolerance without affecting each drug’s unique pharmacological effects. Ipragliflozin may therefore be expected to be effective when administered as part of a combination regimen in the treatment of type 2 diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  • Abdul-Ghani, M.A., L. Norton, and R.A. DeFronzo. 2012. Efficacy and safety of SGLT2 inhibitors in the treatment of type 2 diabetes mellitus. Current Diabetes Reports 12: 230–238.

    Article  CAS  PubMed  Google Scholar 

  • Bailey, C.J., J.L. Gross, D. Hennicken, N. Iqbal, T.A. Mansfield, and J.F. List. 2013. Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial. BMC Medicine. doi:10.1186/1741-7015-11-43.

    PubMed  Google Scholar 

  • Bays, H. 2013. Sodium glucose co-transporter type 2 (SGLT2) inhibitors: targeting the kidney to improve glycemic control in diabetes mellitus. Diabetes Therapy 4: 195–220.

    Article  PubMed Central  PubMed  Google Scholar 

  • Chao, E.C. 2014. SGLT-2 inhibitors: a new mechanism for glycemic control. Clinical Diabetes 32: 4–11.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dahlqvist, A. 1984. Assay of intestinal disaccharidases. Scandinavian Journal of Clinical and Laboratory Investigation 44: 169–172.

    Article  CAS  PubMed  Google Scholar 

  • Do, H.J., T. Jin, J.H. Chung, J.W. Hwang, and M.J. Shin. 2014. Voglibose administration regulates body weight and energy intake in high fat-induced obese mice. Biochemical and Biophysical Research Communications 443: 1110–1117.

    Article  CAS  PubMed  Google Scholar 

  • Ferrannini, E., E. Muscelli, S. Frascerra, S. Baldi, A. Mari, T. Heise, U.C. Broedl, and H.J. Woerle. 2014. Metabolic response to sodium-glucose cotransporter 2 inhibition in type 2 diabetic patients. The Journal of Clinical Investigation 124: 499–508.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Hansen, R.J., H. Hinze, and H. Holzer. 1976. Assay of phosphoenolpyruvate carboxykinase in crude yeast extracts. Analytical Biochemistry 74: 576–584.

    Article  CAS  PubMed  Google Scholar 

  • Kahn, S.E., S.M. Haffner, M.A. Heise, W.H. Herman, R.R. Holman, N.P. Jones, et al. 2006. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. New England Journal of Medicine 355: 2427–2443.

    Article  CAS  PubMed  Google Scholar 

  • Kashiwagi, A., K. Kazuta, Y. Takinami, S. Yoshida, A. Utsuno, and I. Nagase. 2014. Ipragliflozin improves glycemic control in Japanese patients with type 2 diabetes mellitus: the BRIGHTEN study. Diabetol International. doi:10.1007/s13340-014-0164-0.

    Google Scholar 

  • Kim, Y.D., K.G. Park, Y.S. Lee, Y.Y. Park, D.K. Kim, B. Nedumaran, W.G. Jang, W.J. Cho, J. Ha, I.K. Lee, C.H. Lee, and H.S. Choi. 2008. Metformin inhibits hepatic gluconeogenesis through AMP-activated protein kinase-dependent regulation of the orphan nuclear receptor SHP. Diabetes 57: 306–314.

    Article  CAS  PubMed  Google Scholar 

  • Laakso, M. 2010. Cardiovascular disease in type 2 diabetes from population to man to mechanisms. Diabetes Care 33: 442–449.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Lebovitz, H.E. 1997. Alpha-Glucosidase inhibitors. Endocrinology and Metabolism Clinics of North America 26: 539–551.

    Article  CAS  PubMed  Google Scholar 

  • Matsuo, T., H. Odaka, and H. Ikeda. 1992. Effect of an intestinal disaccharidase inhibitor (AO-128) on obesity and diabetes. The American Journal of Clinical Nutrition 55: S314–S317.

    Google Scholar 

  • Merovci, A., C. Solis-Herrera, G. Daniele, R. Eldor, T.V. Fiorentino, D. Tripathy, J. Xiong, Z. Perez, L. Norton, M.A. Abdul-Ghani, and R.A. DeFronzo. 2014. Dapagliflozin improves muscle insulin sensitivity but enhances endogenous glucose production. The Journal of Clinical Investigation 124: 509–514.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Nathan, D.M., J.B. Buse, M.B. Davidson, E. Ferrannini, R.R. Holman, R. Sherwin, and B. Zinman. 2008. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: update regarding thiazolidinediones: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 31: 173–175.

    Article  PubMed  Google Scholar 

  • Rao, A.D., N. Kuhadiya, K. Reynolds, and V.A. Fonseca. 2008. Is the combination of sulfonylureas and metformin associated with an increased risk of cardiovascular disease or all-cause mortality?: a meta-analysis of observational studies. Diabetes Care 31: 1672–1678.

    Article  PubMed Central  PubMed  Google Scholar 

  • Stienstra, R., C. Duval, S. Keshtkar, J. van der Laak, S. Kersten, and M. Müller. 2008. Peroxisome proliferator-activated receptor gamma activation promotes infiltration of alternatively activated macrophages into adipose tissue. Journal of Biological Chemistry 283: 22620–22627.

    Article  CAS  PubMed  Google Scholar 

  • Tahara, A., A. Matsuyama-Yokono, R. Nakano, Y. Someya, M. Hayakawa, and M. Shibasaki. 2009. Evaluation of the antidiabetic effects of dipeptidyl peptidase-IV inhibitor ASP8497 in streptozotocin-nicotinamide-induced mildly diabetic mice. Pharmacology 83: 177–187.

    Article  CAS  PubMed  Google Scholar 

  • Tahara, A., E. Kurosaki, M. Yokono, D. Yamajuku, R. Kihara, Y. Hayashizaki, T. Takasu, M. Imamura, L. Qun, H. Tomiyama, Y. Kobayashi, A. Noda, M. Sasamata, and M. Shibasaki. 2012. Pharmacological profile of ipragliflozin (ASP1941), a novel selective SGLT2 inhibitor, in vitro and in vivo. Naunyn-Schmiedeberg’s Archives of Pharmacology 385: 423–436.

    Article  CAS  PubMed  Google Scholar 

  • Tahara, A., E. Kurosaki, M. Yokono, D. Yamajuku, R. Kihara, Y. Hayashizaki, T. Takasu, M. Imamura, Q. Li, H. Tomiyama, Y. Kobayashi, A. Noda, M. Sasamata, and M. Shibasaki. 2013. Effects of SGLT2 selective inhibitor ipragliflozin on hyperglycemia, hyperlipidemia, hepatic steatosis, oxidative stress, inflammation, and obesity in type 2 diabetic mice. European Journal of Pharmacology 715: 246–255.

    Article  CAS  PubMed  Google Scholar 

  • Tran, L., A. Zielinski, A.H. Roach, J.A. Jende, A.M. Householder, E.E. Cole, S.A. Atway, M. Amornyard, M.L. Accursi, S.W. Shieh, and E.E. Thompson. 2015. The pharmacologic treatment of type 2 diabetes: oral medications. Annals of Pharmacotherapy. doi:10.1177/1060028015573010.

    Google Scholar 

  • Turner, R.C., C.A. Cull, V. Frighi, and R.R. Holman. 1999. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 281: 2005–2012.

    Article  CAS  PubMed  Google Scholar 

  • U.K. Prospective Diabetes Study Group. 1998. UKPDS 28: a randomized trial of efficacy of early addition of metformin in sulfonylurea-treated type 2 diabetes. U.K. Prospective Diabetes Study Group. Diabetes Care 21: 87–92.

    Google Scholar 

  • Wild, S., G. Roglic, A. Green, R. Sicree, and H. King. 2004. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27: 1047–1053.

    Article  PubMed  Google Scholar 

  • Yki-Järvinen, H. 2004. Thiazolidinediones. New England Journal of Medicine 351: 1106–1118.

    Article  PubMed  Google Scholar 

  • Yokono, M., T. Takasu, Y. Hayashizaki, K. Mitsuoka, R. Kihara, Y. Muramatsu, S. Miyoshi, A. Tahara, E. Kurosaki, Q. Li, H. Tomiyama, M. Sasamata, M. Shibasaki, and Y. Uchiyama. 2014. SGLT2 selective inhibitor ipragliflozin reduces body fat mass by increasing fatty acid oxidation in high-fat diet-induced obese rats. European Journal of Pharmacology 727: 66–74.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Drs. Yuichi Tomura, Hideaki Minoura, Yuka Hayashizaki, Shoji Takakura, Seiji Kaku, and Wataru Uchida (Astellas Pharma Inc.) for their valuable comments and continuing encouragement.

Conflict of interest

The authors declare that no conflict of interest exists in the present study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Atsuo Tahara.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tahara, A., Takasu, T., Yokono, M. et al. Effects of the combination of SGLT2 selective inhibitor ipragliflozin and various antidiabetic drugs in type 2 diabetic mice. Arch. Pharm. Res. 39, 259–270 (2016). https://doi.org/10.1007/s12272-015-0621-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12272-015-0621-8

Keywords

Navigation