The 12-Month Administration of Tofogliflozin for Glycemic Control with Monitoring Electrolytes, Renal and Cardiac Function in Japanese Elderly Patients with Type 2 Diabetes Mellitus

Abstract Objective: Tofogliflozin, a new class of glucose-lowering drugs, acts on sodium glucose cotransporter 2 locating on proximal tubules of kidney, excreting excessive glucose by inhibiting the transporter. Due to its mechanism of osmotic diuresis, monitoring of electrolyte and dehydration is important. The present study investigated a time-dependent change of these variables in elderly people. Methods: The treatment was conducted in 81 elderly patients with type 2 diabetes mellitus receiving tofogliflozin for 12 months. Glycated hemoglobin (HbA1c), serum electrolytes (sodium, potassium, chloride) and hematocrit as an index of dehydration were continuously monitored during the investigation period. Results: HbA1c significantly decreased (β1=7.26, β0= − 0.04, p<0.01, by linear regression analysis). Electrolytes, including sodium, and chloride, significantly changed throughout the investigation period.And heamtocrit potassium,eGFR,and BNP did not change throughout the period. Conclusion: A twelve-month administration of tofogliflozin improved glycemic control in type 2 diabetic patients without aggravating the abnormality of serum electrolyte concentration and hematocrit values. This study suggested that 12-month administration of tofogliflozin exhibited glucose-lowering with less risk of drug-induced electrolyte abnormalities, dehydration and aggravating BNP level in elderly patients with type2 diabetes mellitus. Keywords BNP; Elderly Patients; Electrolyte; HbA1c; SGLT2 Inhibitor; Tofogliflozin