SP430BIOIMPEDANCE ANALYSIS OF WEIGHT LOSS ASSOCIATED WITH SODIUM GLUCOSE COTRANSPORTER 2 INHIBITORS

Abstract

INTRODUCTION AND AIMS: Sodium Glucose cotransportes 2 inhibitors (SGLT-2) have changed treatment of type 2 Diabetes melitus (DM2) due to its mechanism of action which is independent of insulin, they prevent therapeutic failure and the risk of hypoglycemia. A weight reduction has been demonstrated during clinical development and post-authorization phase, associated with a diuretic-like effect and a constant caloric loss (70-80 g / day of glucose) in the form of glucosuria, and a decrease of glycated hemoglobin (A1c) is the main effect . The weight reduction could be secondary to loss of fat mass, but this is poorly studied. METHODS: This is an observational, ambispective study from March 2014 until September 2016. DM2 patients who received SGLT-2 (dapagliflozin or empagliflozin), with normal glomerular filtration >=60 ml/min, (CKD 1,2) with different degrees of albuminuria (A) were assessed by bioimpedance. The treatment was in indication, under conditions of clinical use and with previous informed consent. RESULTS: We included 50 patients, 28 men, with a mean age of 57.4 years, SD: 14.3. Time of evolution of DM2 7.4 years, SD: 3.1. Renal function at baseline is MDR CKDEPI: 74.2 ml / min, SD: 12.1. The weight and distribution of the different compartments, total body water (TBW), extracellular water (EW), fat free mass (FFM), muscle mass (MM) and fat mass (FM) are shown in the table. Bioimpedance found overhydration in more than 65% of patients at baseline withouth clinical signs of overhydration. CONCLUSIONS: In our experience, weight reduction studied by bioimpedance, shows a biphasic behavior. A decrease in weight at the expense of TBW compartment is observed in the first control ( 1 month later), in relation to diuretic-like effect. In the final follow-up at 6 months, the weight loss maintained or even increased, it occurs at the expense of a decrease in fat mass. In summary, an initial loss of weight is related to depletion by diuretic effect and the long term reduction is related to fat mass reduction due to continued caloric loss. (Table presented).