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Abstract: FR-PO234

Elevation of Hematocrit and Decrease in Hemoglobin A1c After the Administration of SGLT-2 Inhibitors Have Different Relation with Parameters Reflecting Diuretic Effect

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Wada, Yoshiharu, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Hamamoto, Yoshiyuki, Kansai Electric Power Hospital, Osaka, Japan
  • Nakatani, Yoshihisa, Kinki University, Osaka, Japan
  • Yoshiji, Satoshi, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Honjo, Sachiko, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Aizawa-Abe, Megumi, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Keidai, Yamato, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Seno, Yohei, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Iwasaki, Kanako, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Iwasaki, Yorihiro, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Fujikawa, Jun, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Kakita, Hiroko, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
  • Hamasaki, Akihiro, Tazuke Kofukai Medical Institute Kitano Hospital, Osaka, Japan
Background

Recently, sodium-glucose cotransporter 2 (SGLT-2) inhibitors were indicated to have hematopoietic effect, but it is still unclear whether the effect is independent from its anti-diabetic effect. In this study, we investigated changes in hematocrit and parameters reflecting diuretic change according to HbA1c reaction after administration of SGLT-2 inhibitors in patients with type 2 diabetes.

Methods

A total of 96 patients (male: n=59, age: 54.7±11.8 [mean±SD] years, BMI: 29.6±4.4 kg/m2, HbA1c: 8.7±1.4 %) with type 2 diabetes who were newly administered SGLT-2 inhibitors from July 2014 to January 2018 were retrospectively identified. The patients were divided into two groups according to HbA1c change (responded [ΔHbA1c<-0.5 %] patients; group A: n=52 [male: n=32], age: 53.9±12.1 years, BMI: 29.9±4.5 kg/m2; non-responded [ΔHbA1c≥0.5 %] patients; group B: n=44 [male: n=27], age: 55.5±11.5 years, BMI: 29.3±4.5 kg/m2, HbA1c: 7.9±1.2 %). Changes in HbA1c, hematocrit, urine specific gravity, blood urea nitrogen, serum creatinine and plasma osmolarity levels between before and 30 days after the administration of the drugs were evaluated. Plasma osmolarity was calculated by the formula (2x(Na[mEq/l]+K[mEq/l]))+(BUN[mg/dl]/2.8)+(glucose[mg/dl]/18).

Results

HbA1c was significantly decreased in only group A (group A: -1.03±0.42 %; p<0.001, group B: -0.11±0.46; p=0.65) whereas both groups showed significantly increased hematocrit (group A: 1.8±2.0 %; p=0.007, group B: 2.0±1.8; p=0.035) and urine specific gravity (0.008±0.009 g/mL; p<0.001, 0.011±0.011; p<0.001). Blood urea nitrogen (0.86±3.52 mg/dL; p=0.31, 1.28±3.99; p=0.23), serum creatinine (0.04±0.08 mg/dL; p=0.35, 0.04±0.08; p=0.41), plasma osmolarity (1.11±3.82 mOsm/L; p=0.26, -1.16±5.66; p=0.12) and BMI (-0.61±0.48 kg/m2; p=0.26, -0.51±0.51; p=0.58) did not change in both groups. Group A showed negative correlation between changes in BMI and plasma osmolarity (r=-0.28; p=0.04), whereas group B did not (r=0.14; p=0.36).

Conclusion

Our data suggest that the elevation of hematocrit and decrease in HbA1c after the administration of SGLT-2 inhibitors have different relation with parameters reflecting diuretic effect.