Can ipragliflozin treatment help lower insulin dose in patients with T2D receiving insulin therapy?

This study evaluated the safety and effectiveness of ipragliflozin (Suglat) in patients with type 2 diabetes (T2D). This study concluded that ipragliflozin helped reduce insulin dose by 30%, with minimal side effects.

Treatment for T2D aims to achieve good blood glucose control while avoiding hypoglycemia (dangerously low blood glucose). Insulin therapy is one of the most common treatments for lowering blood glucose levels. However, long-term use of insulin is associated with hypoglycemia and weight gain. This may cause patients to stop using insulin properly.

Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors) such as ipragliflozin help the kidneys remove glucose from the body through the urine. Previous studies have shown that SGLT2 inhibitors can help improve blood glucose levels and promote weight loss in patients with T2D. However, it is not known if SGLT2 inhibitors can help lower insulin doses in patients already on insulin therapy.

This study had 97 patients with T2D. Patients were already on insulin therapy. In this study, patients received 50 mg of once-daily ipragliflozin in addition to insulin. At the start of treatment, patients had insulin doses reduced by 20 to 40% (about 6 units per day). Patients received ipragliflozin for 24 weeks.

On average, patients started the study taking an average of 23.0 units of insulin per day. At the end of the study, ipragliflozin treatment significantly reduced the average daily dose of insulin by 29.87% (6.6 units).

After 2 weeks of treatment, HbA1c (average blood glucose over the past 3 months) levels significantly decreased from 7.62 mmol/L to 7.48 mmol/L. At the end of the study, HbA1c decreased even further to 7.32 mmol/L. Bodyweight was also significantly reduced throughout treatment.

Overall, 60.2% of patients had side effects. Most side effects were mild. The most common side effects were the common cold (17.5%) and frequent urination during the day (13.6%). Hypoglycemia was also reported (10.7%).

This study concluded that ipragliflozin effectively reduced daily insulin dose by 30% in patients with T2D on insulin therapy, with minimal side effects.

This study only included Japanese patients, so these results may not apply to all patients. This study also had a small number of patients and did not have a control group for comparison. Also, ipragliflozin may not be available in all countries, as it has been approved for T2D in Japan and Korea. The study received funding support from Astellas, the manufacturer of ipragliflozin.