As-required administration of sodium glucose co-transporter-2 inhibitors: three case studies

  • Yoko Shimoda
  • Eijiro Yamada
  • Tsugumichi Saito
  • Yawara Niijima
  • Junichi Okada
  • Shuichi Okada
  • Masanobu Yamada
Commentary
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Abstract

Sodium glucose co-transporter-2 (SGLT2) inhibitors are used to reduce glycated hemoglobin (HbA1c) levels. Although they have the potential to reduce body weight in patients with type 2 diabetes mellitus (T2DM), some patients may gain weight. We found that the effects of the SGLT2 inhibitor ipragliflozin were maintained for 48 h when used in combination with nifedipine, so we considered that a daily SGLT2 inhibitor might be unnecessary. Therefore, we investigated whether as-required single doses of an SGLT2 inhibitor would be clinically relevant in three patients having difficulty maintaining blood glucose control when they were unable to exercise or during social situations. All three patients demonstrated improved HbA1c levels with as-required single doses of an SGLT2 inhibitor. These patients experienced no adverse effects or weight gain relative to taking an SGLT2 inhibitor daily. Thus, as-required single-dose SGLT2 inhibitors could be one of the many options to improve blood glucose control in T2DM.

Notes

Acknowledgements

The authors thank Dr. Jeffrey E Pessin (Albert Einstein College of Medicine, Bronx, NY, USA) for critical suggestions on our manuscript.

Author Contributions

YS, YN, and SO provided patient care. YS, EY, TS, YN, JO, SO, and MY participated in the discussion and prepared the manuscript.

Declarations

Ethics approval and consent to participate

Written informed consent was obtained from the patients for the publication of this manuscript and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Consent to publish

All authors understand that the information will be published without patients’ names, but that full anonymity cannot be guaranteed. We understand that the text will be available on the internet and in print and may be seen by the general public, translated into other languages, or used for commercial purposes.

Conflict of interest

The authors have no significant competing financial, professional, or personal interests that might have influenced the performance or presentation of the work described in this manuscript.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Yoko Shimoda
    • 1
  • Eijiro Yamada
    • 1
  • Tsugumichi Saito
    • 1
    • 2
  • Yawara Niijima
    • 2
  • Junichi Okada
    • 1
    • 2
  • Shuichi Okada
    • 1
    • 2
  • Masanobu Yamada
    • 1
  1. 1.Division of Endocrinology and Diabetes MellitusGunma University HospitalMaebashiJapan
  2. 2.Kan-etsu HospitalTakasakiJapan

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