1,5-anhydroglucitol is a good predictor for the treatment effect of the Sodium-Glucose cotransporter 2 inhibitor in Japanese patients with type 2 diabetes mellitus

BACKGROUND AND AIMS: The suitable selection of appropriate medicines is one of important factor in successful diabetes care. We looked for clinical indicators that could predict the effects of SGLT2 inhibitors in advance. METHODS AND RESULTS: In a single-center, this retrospective study was designed to examine predictive indices of the effectiveness of SGLT2 inhibitors. Using the medical records of 169 patients, we investigated the differences in clinical data between a group with improved glycemic control and a group with less improved glycemic control. 32 weeks of treatment with SGLT2 inhibitors decreased the HbA1c levels by 0.71%. The glucose-lowering effect was associated with improvement of the liver function. The maximum BMI change was independent of the rate of the HbA1c reduction. The HbA1c reduction was greater in patients with low 1,5-AG. This determination was unaffected by the use of anti-diabetic medication. Limiting HbA1c from 7.0% (52 mmol/mol) to 8.4% (68 mmol/mol) did not change this tendency. The maximum sum of sensitivity and specificity for patients with an HbA1c improvement of more than 0.7% was obtained with a 1,5-AG cutoff level of 7.65 µg/mL. CONCLUSION: The use of SGLT2 inhibitors in patients with T2DM, 1,5-AG was identified as the most reliable indicator for predicting HbA1c reduction.