Effects of carbohydrate consumption on luseogliflozin activity

This study compared the effects of Lusefi (luseogliflozin) in people with type 2 diabetes (T2D) who had different carbohydrate intakes. It determined that luseogliflozin reduced glucose levels, regardless of carbohydrate intake.

Luseogliflozin is an SGLT2 inhibitor. SGLT2 is a protein in the kidneys that is important in controlling blood glucose levels. It allows glucose to re-enter blood from the kidneys. SGLT2 inhibitors are a type of drug that prevent this. In this way they lower blood glucose levels.

Carbohydrate intake in the diet can also affect blood glucose levels. Glycemic index (GI) is a measure of how fast blood glucose levels rise after a meal. It is not clear whether carbohydrate intake changes the effectiveness of the SGLT2 inhibitors such as luseogliflozin. 

This study examined 24 people with T2D. The participants were randomly divided into 3 groups. Each group received test meals for 14 days. During the last 7 days they were given luseogliflozin. 1 group received meals with high-carbohydrates and high GI (HC-HGI). Another received high-carbohydrate and low GI meals (HC-LGI). The last group received low-carbohydrate and high GI meals (LC-HGI). Blood samples were taken on days 1, 8, and 15. Glucose levels were monitored continuously before (days 5-8) and after (days 12-15) treatment with luseogliflozin.

Glucose levels were highest in the HC-HGI group. However, glucose levels decreased in all groups during luseogliflozin treatment. Fasting blood glucose levels were similar for all groups, and fell during luseogliflozin treatment. Insulin and C-peptide (protein linked to insulin) were similar in all groups, and were lower on days 8 and 15 than on day 1. Glucagon (hormone that opposes insulin) was similar for all groups, and lower on day 15 than on day 1.

Ketone bodies (chemicals made when the body does not have enough glucose or enough insulin) were similar for all groups on days 1 and 8. Luseogliflozin appeared to significantly increase ketone bodies in the LC-HGI group on day 15. High ketone bodies can lead to diabetic ketoacidosis, a life-threatening emergency. Side effects (such as drowsiness) were mild in severity.

The study concluded that luseogliflozin reduced glucose levels, and that this was not affected by differences in carbohydrate intake. It also concluded that while most side effects are mild, luseogliflozin may increase the risk of diabetic ketoacidosis in people with low-carbohydrate intakes.

This study examined only a small number of patients for a short period of time. This could affect accuracy. The patients in this study were all Japanese and almost all were male. Thus the results may not apply equally to all patients with T2D. Furthermore this study was funded by the manufacturers of luseogliflozin. 

Discuss the use of luseogliflozin and other SGLT2 inhibitors with your physician.