Acute effect of add-on therapy with tofogliflozin, a sodium glucose
co‐transporter 2 inhibitor, on 24-hour glucose profile and glycemic
variability evaluated by continuous glucose monitoring in patients with
type 2 diabetes receiving dipeptidyl peptidase-4 inhibitors.
Aim: To investigate acute effects of add-on therapy with the sodium
glucose co‐transporter 2 inhibitor tofogliflozin to dipeptidyl peptidase
(DPP)-4 inhibitors on 24-hour glucose profile and glycemic variability
evaluated by continuous glucose monitoring (CGM) in patients with type 2
diabetes. Patients and methods: We studied 17 patients with type 2
diabetes who were hospitalized for glycemic control. CGM was performed
for 7 consecutive days in the last week of hospitalization.
Tofogliflozin 20 mg/day was started on day 4 after initiating CGM and
was administered to 10 patients receiving DPP-4 inhibitors and 7
patients not receiving DPP-4 inhibitors. We compared several CGM
parameters between day 2 to 3 (ie, before treatment with tofogliflozin)
and day 5 to 6 (ie, after starting treatment with tofogliflozin).
Results: After starting treatment with tofogliflozin, mean 24-hour
glucose and postprandial glucose after each meal were significantly
decreased in both groups of patients. Time in range (ie, at a glucose
level of 70-180 mg/dL) was significantly increased in both groups. The
standard deviation of 24-hour glucose and mean amplitude of glycemic
excursions, 2 indexes of glycemic variability, were significantly
decreased in patients receiving DPP-4 inhibitors but were unchanged in
those not receiving these drugs. Conclusions: Add-on therapy with
tofogliflozin to DPP-4 inhibitors acutely reduces 24-hour glucose levels
and improves glycemic variability in patients with type 2 diabetes.