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of SGLT2 inhibitors. Thus, it is controversial whether we
should continue SGLT2 inhibitor administration in the long
term after having obtained the expected beneficial metabolic
effects. We therefore examined the 1-year clinical course of
patients with type 2 diabetes mellitus after discontinuation of
the SGLT2 inhibitor tofogliflozin.
Methods:
Twenty-one patients with type 2 diabetes mellitus
who were treated with 20 or 40 mg/day tofogliflozin for 52
weeks participated in this study (monotherapy, n = 9; combin-
ation therapy with sulfonylureas, n = 12). All the patients were
involved in the Phase 3 clinical study of tofogliflozin in
Japanese patients with type 2 diabetes mellitus. After discon-
tinuation of tofogliflozin, changes in clinical parameters
including body weight, HbA1c, serum lipid concentrations
and liver enzymes were observed for the following year.
Results:
Patient body weight decreased an average of 3.1 kg
after tofogliflozin administration for 52 weeks, but increased
2.1 kg on average in the 3 months following tofogliflozin
discontinuation. Furthermore, body weight returned to the
level before treatment within one year. HbA1c levels also
decreased an average of 1.1% after tofogliflozin administra-
tion, but increased 0.4% in the first 3 months after discontinu-
ation of the drug, and interventions with other classes of
hypoglycemic agents were performed in 19 of the 21 patients.
Similarly, alanine aminotransferase and
γ
-glutamyltransfer-
ase significantly decreased during the tofogliflozin treat-
ment period, but increased again after discontinuation of
tofogliflozin.
Conclusion:
The pharmacological effect of the SGLT2 inhibitor
tofogliflozin disappeared immediately following drug dis-
continuation, and increases in body weight, HbA1c and the
liver enzymes were observed within 3 months in most cases.
Therefore, careful assessment of patients, including behav-
ioral changes and their metabolic condition, is necessary for
making a decision on continuation/discontinuation of SGLT2
inhibitors.
PD-37
The effect of rice-bran dietary fiber on postprandial blood
glucose for Type II diabetic patients
TzuYing WU
1
*, WenHuy CHEN
1
.
1
Nutrition & Dietetics Division of
the Lukang Branch of Changhua Hospital, Taiwan
Dietary fiber has important role in the management of
postprandial blood glucose (PBG) control for diabetic patients.
The rice bran that is left over from the rice refinement process
has a large amount of dietary fiber. Therefore, the effect of
rice-bran dietary fiber (RDF) on PBG among Type II diabetic
patients was investigated. A total of nine volunteering Type II
diabetic patients were enrolled in this study. The patients were
given, on two separate days, the same breakfasts (including
60 grams carbohydrates) that were with RDF (10 g) or RDF-free.
Fasting and postprandial blood was collected at intervals
of 30 min for 180 min to determine whole blood glucose.
The results indicated that the use of RDF can significantly
reduce the area under the curve (AUCglucose) for the PBG
plot (36360 ± 6073 vs. 32560 ± 5546.7 mg/dL ×min, P < 0.05) as
well as shortened the PBG peak values and peak time. In
conclusion, rice bran dietary fiber can be used to improve PBG
for Type II Diabetic Patients.
PD-38
The effect of SGLT2 inhibitors on drug-naive obese type 2
diabetes mellitus patients
Shinji CHIKAZAWA
1
, Yuki MATSUHASHI
2
*, Yusuke TANDO
2
,
Makoto DAIMON
2
.
1
Tsugaru General Hospital,
2
Hirosaki University
Graduate School of Medicine, Japan
We administered sodium glucose cotransporter 2 (SGLT2)
inhibitors to drug-naive obese type 2 diabetes mellitus (T2D)
patients for 3 or 4 months. We report changes in blood sugar
control of 3 patients. Case 1: 20 mg tohogliflozin for 4 months
was administered to 47 year-old female whose duration of
diabetes mellitus (DM) was about 3 years. Body weight (BW)
was reduced from 85.9 kg to 71.1 kg. Blood sugar levels before
meals (preprandial) were lowered from166 mg/dL to 97 mg/dL.
HbA1c was improved from 8.7% to 5.3%. Imunoreactive insulin
(IRI) levels decreased from 7.49 mcIU/mL to 4.89 mcIU/mL.
Serum C-peptide reactivity (S-CPR) decreased from 2.54 ng/mL
to 1.75 ng/mL. Case 2: 50 mg ipragliflozin for 4 months was
administered to 64 year-old male whose duration was about 4
years. BW was reduced from 79.3 kg to 75.8 kg. Preprandial
blood sugar was lowered from 202 mg/dL to 162 mg/dL.
HbA1c was improved from 10.7% to 7.6%. IRI increased from
3.06 mcIU/mL to 7.39 mcIU/mL. S-CPR increased from 1.73 ng/
ml to 2.65 ng/mL. Case 3: 5 mg dapagliflozin for 3 months
was administered to 43 year-old male whose duration was
about 1 month. BW was reduced from 95.3 kg to 83.5 kg.
Preprandial blood sugar was lowered from 134 mg/dL to 96 mg/
dL. HbA1c was improved from 7.9% to 5.7%. IRI decreased from
11.86 mcIU/mL to 8.94 mcIU/mL. S-CPR decreased from
2.13 ng/mL to 1.61 ng/mL. The improvements of their clinical
condition were much due to the loss of their body weight.
Insulin resistance could be reduced by the loss of body weight.
Insulin resistance is the essential of T2D. Adiponectin levels
were slightly increased in Case 1 and Case 2. Free fatty acidwas
decreased in Case 3. These phenomena indicated that SGLT 2
inhibitor could increase one of insulin sensitivity enhancers,
and decrease one of induction factors of insulin resistance. In
Case 1 and in Case 3, the patients took care of their BW, and
they stopped snacking. As the patient of Case 2 could not stop
snacking, neither IRI nor S-CPR were improved. When SGLT2
inhibitors are administered to drug-naïve obese T2D patients
who observe the compliance to dietary, we may expect the
improvement of their insulin resistance and SGLT2 inhibitors
could cure the essential of T2D.
PD-39
Plasma serpinB1 levels are strongly correlated with circulating
ANGPTL8 levels in patients with type 2 diabetes
Shinsuke TOKUMOTO
1
*, Akihiro HAMASAKI
1
, Emi OKAMURA
1
,
Yukiko KAWASAKI
1
, Sachiko HONJO
1
, Yoshiyuki HAMAMOTO
2
.
1
Centre for Diabetes and Endocrinology, Tazuke Kofukai Foundation,
Medical Research Institute, Kitano Hospital, Osaka,
2
Center for
Diabetes, Endocrinology, and Metabolism, Kansai Electric Power
Hospital, Japan
Background and aims:
SerpinB1, a protease inhibitor secreted
by the liver, has recently been described as a potent stimulator
that increases beta cell proliferation in mice and humans.
While we previously reported that ANGPTL8 correlated with
insulin secretion capacity, the pathophysiological role of
SerpinB1 in patients with type 2 diabetes mellitus (T2DM)
remains poorly understood. The aim of the study was to
evaluate the relationship between plasma SerpinB1 levels
and other biomarkers including ANGPTL8.
Materials and methods:
Overnight fasting plasma samples
from 8 healthy subjects and 69 T2DM patients were collected.
HbA1c, fasting plasma glucose, total cholesterol, triacylgly-
cerol, and creatinine clearance (CrCl) calculated by 24-hour
urine collection were measured in all T2DM patients. Plasma
levels of serpinB1 (Cusabio, Catalogue No. CSB-EL021065HU)
and ANGPTL8 (Eiaab, Catalogue No. E11644h) were determined
by enzyme-linked immunosorbent assay according to the
manufacturer
’
s protocol. Correlations were evaluated by
Spearman
’
s rank test. P values <0.05 were considered statis-
tically significant.
Results:
Plasma serpinB1 levels were significantly higher in
T2DM patients (0.53 ± 0.28 ng/mL) than in healthy subjects
(0.21 ± 0.16 ng/mL; p < 0.05). In T2DM patients, plasma
serpinB1 levels showed a significant positive association with
ANGPTL8 (r = 0.47 p < 0.001). Both serpinB1 and ANGPTL8 levels
Poster Presentations / Diabetes Research and Clinical Practice 120S1 (2016) S65
–
S211
S103