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This study investigated the safety and efficacy of the sodium‐glucose co‐transporter‐2 ( SGLT2 ) inhibitor luseogliflozin with differing carbohydrate intakes in  J apanese individuals with type 2 diabetes ( T2D ). Participants were randomly assigned to 3 carbohydrate‐adjusted meals for 14 days (days 1‐14; a high carbohydrate [ HC ; 55% total energy carbohydrate] and high glycaemic index [ HGI ] meal; an  HC  [55% total energy carbohydrate] and low glycaemic index [ LGI ] meal; or a low carbohydrate [ LC ; 40% total energy carbohydrate] and  HGI  meal). All participants received luseogliflozin for the last 7 days (days 8‐14), continuous glucose monitoring ( CGM ) before and after luseogliflozin treatment (days 5‐8 and days 12‐15) and blood tests on days 1, 8 and 15. Luseogliflozin significantly decreased the area under the curve and mean of  CGM  values in all 3 groups similarly. Fasting plasma glucose, insulin and glucagon were similar at all time points. Ketone bodies on day 15 were significantly higher in the  LC‐HGI  group compared with the  HC‐HGI  and  HC‐LGI  groups. In conclusion, luseogliflozin has similar efficacy and safety in  J apanese people with  T2D  when meals contain 40% to 55% total energy carbohydrate, but a strict  LC  diet on this class of drug should be avoided to prevent  SGLT2  inhibitor‐associated diabetic ketoacidosis.

diabetes, obesity and metabolism

Sodium‐glucose co‐transporter‐2 inhibitor use and dietary carbohydrate intake in  J apanese individuals with type 2 diabetes:  A  randomized, open‐label, 3‐arm parallel comparative, exploratory study