A Four-Week Treatment With Dapagliflozin Is Associated With a Reduction in Insulin-Stimulated Renal Cortical Glucose Uptake: A Post Hoc Analysis From a Pilot Study
Abstract
Introduction and objective: Treatment with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) reduces the risk of both cardiovascular and renal outcomes in type 2 diabetes (T2D). The specific mechanism by which this happens has not yet been clarified. Recent findings indicate that, in obese individuals, the kidney exhibits lower 18-fluorodeoxyglucose ([18F]-FDG) uptake rates compared to lean individuals, possibly due to insulin resistance. This post hoc analysis from our pilot study DAPAHeart aims to evaluate changes in cortical renal [18F]-FDG uptake in T2D patients following short-term treatment with dapagliflozin.
Methods: In our DAPAHeart trial, a single-centre, 4-week, prospective, double-blind, controlled study, we enrolled T2D patients with stable coronary artery disease and preserved glomerular filtration rates. Participants were randomly assigned in a 1:1 ratio to receive either dapagliflozin (10 mg daily) or a placebo. PET scans using [18F]-FDG were performed during a hyperinsulinemic-euglycemic clamp (HEC) to measure regional FDG uptake before and after the 4-week treatment with SGLT-2i.
Results: After 4 weeks of treatment, the between-group comparison (Mann-Whitney U test on change-from-baseline values) did not reach statistical significance for any SUV parameter. Nevertheless, a consistent directional pattern in renal standardised uptake value (SUV) was noted across all parameters, with reductions observed in the dapagliflozin group and stable or slightly…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 7 participants or records.
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