Diabetes Case Reports

Abstract

Remarkable Improvement of Glucose Variability by Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors using Continuous Glucose Monitoring (CGM)

Koji Ebe, Hiroshi Bando, Tetsuo Muneta, Masahiro Bando and Yoshikazu Yonei

Authors have continued clinical research of Calorie Restriction (CR) and Low Carbohydrate Diet (LCD) and
present a case with precise observation of continuous glucose monitoring (CGM). The patient is 38 years-old
females with type 2 diabetes mellitus (T2DM), who showed BMI 19.6, postprandial blood glucose 277 mg/dL. HbA1c
12.6%, glycoalbumin 31.8% (11.6-16.4), HOMA-R 2.8, HOMA-β 8.5, urinary excretion of C-peptide 67 μg/day, and
normal range of liver, renal, lipid exams. She was given three stage intervention. The protocol was
• Day 1-2; CR meal with 60% carbohydrate,
• Day 3-5; LCD meal with 12% carbohydrate,
• Day 6-13; LCD+Sodium–glucose cotransporter 2(SGLT2) inhibitors (Suglat 50 mg, Ipragliflozin L-Proline).
The glucose variability was monitored using FreeStyle Libre Pro (Abbott) for 14 days. Blood glucose was
decreased as
• More than 350 mg/dL,
• 180-200 mg/dL,
• 100-150 mg/dL in day 7-9, and 90-120 mg/dL in day 10-13.
Acute decrease of blood glucose was found 3 hours after giving Suglat, which was remarkable finding. These
results suggest the improving glucose variability of LCD in short term, the acute and strong efficacy of SGLT2
inhibitors for glucose metabolism, and clinical usefulness of simultaneous observation of glucose fluctuation.

Published Date: 2019-01-28; Received Date: 2018-12-28