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A study published in the journal Diabetes, Obesity & Metabolism examined the effects of semaglutide injections on treatment satisfaction and eating behavior in Japanese patients with type 2 diabetes mellitus (T2DM). The study found that semaglutide injections increased treatment satisfaction and improved eating behavior in patients with T2DM, particularly those with obesity. The injections also resulted in decreased body weight and HbA1c levels in both groups. However, adverse events were reported, with loss of appetite being the most frequent. The study suggests that semaglutide injections may be a beneficial treatment option for Japanese patients with T2DM and obesity, but further research is needed to confirm these findings. [Extracted from the article]

Aims/Introduction: Severe diabetic macular edema (DME) is often resistant to anti‐vascular endothelial growth factor therapy. Steroids are particularly effective at reducing edema by suppressing inflammation; they are also used as an alternative to expensive anti‐vascular endothelial growth factor therapy in some patients. Therefore, the use of steroids in DME reflects an unmet need for anti‐vascular endothelial growth factor therapy. Notably, triamcinolone acetonide (TA) injections are widely used in Japan. Here, we evaluated the frequency of TA as an indicator of the efficacy of sodium–glucose cotransporter 2 inhibitors (SGLT2is) in DME treatment using a health insurance claims database. Materials and Methods: In this cohort study, we retrospectively analyzed the health insurance claims data of 11 million Japanese individuals from 2005 to 2019. The frequency and duration of TA injection after the initiation of SGLT2is or other antidiabetic drugs were analyzed. Results: Among the 2,412 matched patients with DME, the incidence rate of TA injection was 63.8 times per 1,000 person‐years in SGLT2i users and 94.9 times per 1,000 person‐years in non‐users. SGLT2is reduced the risk for the first (P = 0.0024, hazard ratio 0.66, 95% confidence interval 0.50–0.87), second (P = 0.0019, hazard ratio 0.53, 95% confidence interval 0.35–0.80) and third TA (P = 0.0053, hazard ratio 0.44, 95% confidence interval 0.25–0.80) injections. A subanalysis of each baseline characteristic of the patients showed that SGLT2is were effective regardless of the background factors. Conclusions: The use of SGLT2is reduced the frequency of TA injection in patients with DME. Therefore, SGLT2i therapy might be a novel, noninvasive and low‐cost adjunctive therapy for DME. [ABSTRACT FROM AUTHOR]

Aim: We assessed the effectiveness of sodium‐glucose co‐transporter 2 inhibitors (SGLT2is) in reducing the administration frequency of anti‐vascular endothelial growth factor (VEGF) agents in patients with diabetic macular oedema (DMO) using a health insurance claims database. Materials and Methods: This retrospective cohort study analysed health insurance claims data covering 11 million Japanese patients between 2005 and 2019. We analysed the frequency and duration of intravitreal injection of anti‐VEGF agents after initiating SGLT2is or other antidiabetic drugs. Results: Among 2412 matched patients with DMO, the incidence rates of anti‐VEGF agent injections were 230.1 per 1000 person‐year in SGLT2i users and 228.4 times per 1000 person‐year in non‐users, respectively, and the risk ratio for events was unchanged in both groups. Sub‐analysis of each baseline characteristic of the patients showed that SGLT2is were particularly effective in patients with a history of anti‐VEGF agent use [p =.027, hazard ratio (HR): 0.44, 95% confidence interval (CI): 0.22‐0.91]. SGLT2is reduced the risk for the first (p =.023, HR: 0.45, 95% CI: 0.22‐0.91) and second (p =.021, HR: 0.39, 95% CI: 0.17‐0.89) anti‐VEGF agent injections. Conclusions: There was no difference in the risk ratio for the addition of anti‐VEGF therapy between the two treatment groups. However, the use of SGLT2is reduced the frequency of anti‐VEGF agent administration in patients with DMO requiring anti‐VEGF therapy. Therefore, SGLT2i therapy may be a novel, non‐invasive, low‐cost adjunctive therapy for DMO requiring anti‐VEGF therapy. [ABSTRACT FROM AUTHOR]

Study Objective: The effects of the sodium‐dependent glucose transporter‐2 inhibitor ipragliflozin were compared with metformin in a previous study, which revealed that ipragliflozin reduced visceral fat content by 12%; however, the underlying mechanism was unclear. Therefore, this sub‐analysis aimed to compare metabolomic changes associated with ipragliflozin and metformin that may contribute to their biological effects. Design: A sub‐analysis of a randomized controlled study. Setting: Chiba University Hospital and ten hospitals in Japan. Patients: Fifteen patients with type 2 diabetes in the ipragliflozin group and 15 patients with type 2 diabetes in the metformin group with matching characteristics, such as age, sex, baseline A1C, baseline visceral fat area, smoking status, and concomitant medication. Interventions: Ipragliflozin 50 mg or metformin 1000 mg daily. Measurements: The clinical data were reanalyzed, and metabolomic analysis of serum samples collected before and 24 weeks after drug administration was performed using capillary electrophoresis time‐of‐flight mass spectrometry. Main Results: The reduction in the mean visceral fat area after 24 weeks of treatment was significantly larger (p = 0.002) in the ipragliflozin group (−19.8%) than in the metformin group (−2.5%), as were the subcutaneous fat area and body weight. The A1C and blood glucose levels decreased in both groups. Glutamic pyruvic oxaloacetic transaminase, γ‐glutamyl transferase, uric acid, and triglyceride levels decreased in the ipragliflozin group. Low‐density lipoprotein cholesterol levels decreased in the metformin group. After ipragliflozin administration, N2‐phenylacetylglutamine, inosine, guanosine, and 1‐methyladenosine levels increased, whereas galactosamine, glucosamine, 11‐aminoundecanoic acid, morpholine, and choline levels decreased. After metformin administration, metformin, hypotaurine, methionine, methyl‐2‐oxovaleric acid, 3‐nitrotyrosine, and cyclohexylamine levels increased, whereas citrulline, octanoic acid, indole‐3‐acetaldehyde, and hexanoic acid levels decreased. Conclusions: Metabolites that may affect visceral fat reduction were detected in the ipragliflozin group. Studies are required to further elucidate the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Keywords: body composition; clinical trial; metformin; obesity therapy; SGLT2 inhibitor; type 2 diabetes EN body composition clinical trial metformin obesity therapy SGLT2 inhibitor type 2 diabetes 3071 3075 5 09/06/23 20231001 NES 231001 BACKGROUND The Japanese Diabetes Society has released an algorithm for pharmacotherapy for patients with type 2 diabetes (T2D).[1] It recommends metformin and sodium-glucose co-transporter 2 (SGLT2) inhibitors for patients with obesity. Urinary 1 microglobulin level is useful for selecting sodium-glucose transporter 2 inhibitor or metformin for visceral fat reduction in patients with type 2 diabetes The results prove that ipragliflozin is effective for reducing VFA in patients with high fasting insulin, low urinary 1MG, or high GPT levels, while metformin is effective for reducing VFA in patients with high HbA1c or urinary 1MG levels. The sodium-glucose cotransporter 2 inhibitor ipragliflozin improves liver function and insulin resistance in Japanese patients with type 2 diabetes. [Extracted from the article]

Aims/Introduction: Recent randomized clinical trials have suggested that sodium–glucose cotransporter 2 inhibitors might reduce cardiovascular events and heart failure, and have renal protective effects. Despite these remarkable benefits, the effects of sodium–glucose cotransporter 2 inhibitors on bone and muscle are unclear. Materials and Methods: A subanalysis of a randomized controlled study was carried out to evaluate the effects of the sodium–glucose cotransporter 2 inhibitor, ipragliflozin, versus metformin on bone and muscle in Japanese patients with type 2 diabetes mellitus (baseline body mass index ≥22 kg/m2 and hemoglobin A1c 7–10%) who were already receiving sitagliptin. These patients were randomly administered ipragliflozin 50 mg or metformin 1,000–1,500 mg daily. The effects of these medications on the bone formation marker, bone alkali phosphatase; the bone resorption marker, tartrate‐resistant acid phosphatase 5b (TRACP‐5b); handgrip strength; abdominal cross‐sectional muscle area; and bone density of the fourth lumbar vertebra were evaluated. Results: After 24 weeks of treatment, the changes in bone density of the fourth lumbar vertebra, handgrip strength and abdominal cross‐sectional muscle area were not significantly different between the two groups. However, TRACP‐5b levels increased in patients treated with ipragliflozin compared with patients treated with metformin (median 11.94 vs −10.30%, P < 0.0001), showing that ipragliflozin can promote bone resorption. Conclusions: There were no adverse effects on bone or muscle when sitagliptin was used in combination with either ipragliflozin or metformin. However, ipragliflozin combination increased the levels of TRACP‐5b. A long‐term study is required to further understand the effects of this TRACP‐5b increase caused by ipragliflozin. [ABSTRACT FROM AUTHOR]

A prospective, multicentre, open‐label, blinded‐endpoint, randomized controlled study was conducted to evaluate the efficacy of treatment with ipragliflozin (sodium‐dependent glucose transporter‐2 inhibitor) versus metformin for visceral fat reduction and glycaemic control among Japanese patients with type 2 diabetes treated with sitagliptin, HbA1c levels of 7%‐10%, and body mass index (BMI) ≥ 22 kg/m2. Patients were randomly assigned (1:1) to receive ipragliflozin 50 mg or metformin 1000‐1500 mg daily. The primary outcome was change in visceral fat area as measured by computed tomography after 24 weeks of therapy. The secondary outcomes were effects on glucose metabolism and lipid metabolism. Mean percentage reduction in visceral fat area was significantly greater in the ipragliflozin group than in the metformin group (−12.06% vs. −3.65%, P = 0.040). Ipragliflozin also significantly reduced BMI, subcutaneous fat area, waist circumference, fasting insulin, and homeostatic model assessment (HOMA)‐resistance, and increased HDL‐cholesterol levels. Metformin significantly reduced HbA1c and LDL‐cholesterol levels and increased HOMA‐beta. There were no severe adverse events. The use of ipragliflozin or metformin in combination with dipeptidyl peptidase‐4 inhibitors, widely used in Japan, may have beneficial effects in ameliorating multiple cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

The article discusses case study of a 58-year-old Japanese woman with Werner Syndrome (WS). It has been informed that she exhibited graying and loss of hair, a hoarse voice, refractory skin ulcers, bilateral juvenile cataracts, dyslipidemia and diabetes and WS was confirmed by genomic DNA analysis. It has been informed that the study found that sitagliptin could be an alternative choice for treatment of diabetes in patients with WS.