SGLT-2 inhibitor effect regarding anthropometric measurements and blood sugar regulation on obese and non-obese patients who have type 2 diabetes

Objective: Obesity is a kind of metabolic disorder that generally accompanies type 2 diabetes as well as a risk factor indicating who is likely to have type 2 diabetes. Although, all obese patients do not have type 2 diabetes, most of type 2 diabetes patients suffer from obesity. Even %5 weight loss can lead to decreasing insulin resistance in obese and insulin resistant patients. Which is why, agents which can promote weight loss become more popular lately. SGLT-2 inhibitors (Sodium Glucose cotransporter-2 inhibitors) are being considered the new agents that have been being prescribed for diabetes treatment for the last 10 years. Medication's main effect mechanism is enhancing glucose secretion in proximal tubules by hindering glucose uptake. Promoting weight loss and positive effect on blood pressure were noted in clinical trials. In our study, we aimed to evaluate the effect of SGLT2 inhibitor use on diabetes regulation using anthropometric measurements (waist circumference, hip circumference, BMI and Bioelectric Impedance Measurement) in obese and non-obese diabetic patients. Materials and Methods: Obese (BMI≥30) and non-obese (BMI<30) patients diagnosed with type 2 diabetes mellitus who applied to our university's internal medicine outpatient clinics were planned to be included in the study. In the study, SGLT2 inhibitor was added to the patients' current diabetes treatment without interfering with the number of meals they ate, their diet, or their exercise programs. Patients' initial anthropometric measurements (waist circumference, hip circumference, height, weight, BMI, Bioelectrical Impedance Measurements) and laboratory data (glucose, uric acid, AST, ALT, albumin, total cholesterol, LDL, HDL, triglyceride levels, HbA1c, CRP) were recorded. The patients were invited for a check-up at the 1st month to monitor their blood sugar. Anthropometric measurements, laboratory values, and laboratory values of the patients for whom the decision was made to continue treatment were recorded and compared statistically with the baseline values between the groups. Results: The study group consisted of 40 people that covered 12 obese women, 8 obese men and 13 non-obese men, 7 non-obese women. No statistically significant difference was measured in gender distribution between the groups (p = 0,11). The average age of the obese group was 62±11 years, and the average age of the non obese group was 61±11 years. There was no statistically significant difference between the average ages of the groups (p = 0,69). BMI (%), weight (kg), waist circumference (cm), bioelectrical impedance measurements fat (%) values of the patients in the study population were found to be statistically significantly lower at the 3rd month after treatment compared to the onset of study. Bioelectrical impedance measurements muscle percentage (%) of the patient population was found to be statistically significantly higher at the 3rd month control of the treatment compared to the baseline (p<0,001). Hip circumference (cm) values of the patient group at the 3rd month after treatment were found to be statistically significantly lower than at the beginning (p = 0,001). The difference between the average HbA1c(%) and glucose (mg/dL) levels of the study population before treatment and in the 3rd month of treatment was found to be statistically significantly lower (p<0,001). The difference between the study group's CRP (mg/dL), ALT (U/L), LDL (mg/dL), total cholesterol (mg/dL) levels before treatment and in the 3rd month of treatment was found to be statistically significantly lower (Consecutively, p=0,009 p=0,022 p=0,003 p=0,021). The difference between the patients' average albumin (g/L) and hct (%) levels before treatment and in the 3rd month of treatment was found to be statistically significantly higher (p=0,002 p<0,001, respectively).Conclusion: In addition to contributing to blood sugar regulation in diabetic patients, SGLT2 inhibitors have a significant effect on improving the clinical and laboratory parameters of patients by helping them lose weight and achieving this weight loss without losing % muscle or % water, losing % fat, reducing central obesity with a decrease in waist circumference. As a result of that, we consider that the use of SGLT 2 inhibitors will be beneficial, especially in the treatment of obese diabetic patients. KEYWORDS: Obesity, Type 2 Diabetes Mellitus Sodium-Glucose Co Transporter 2 Inhibitors, Waist Circumference Measurement, Bioelectric Impedance Measurement