Effect of Dapagliflozin on Fat and Carbohydrate Metabolism in Patients with Type 2 Diabetes Mellitus

Aim: To determine the effects of dapagliflozin in impaired carbohydrate and fat metabolism in type 2 diabetes mellitus (T2DM). Design: An open cohort controlled prospective study. Materials and methods. In this study 60 patients with T2DM and obesity were examined. Dapagliflozin 10 mg was added to metformin monotherapy. Carbohydrate metabolism and fat metabolism markers were evaluated for 6 months: anthropometry, body composition analysis, assessment of adipokines (adiponectin, leptin, irisin, interleukin (IL) 6) and lipid panel. Results. Dapagliflozin addition resulted in glycated hemoglobin level decrease by an average of 0.6% (p = 0.093) along with significant positive effects on fat metabolism markers. The mean body mass decrease was 3.3 kg (p < 0.05). There was also a significant decrease in fat mass of 3 kg (p = 0.001) and a muscle mass extension, according to a body composition analysis report, which correlated with leptin levels decrease (p = 0.073) and adiponectin and irisin levels increase (p < 0.05). A significant decrease in total cholesterol, triglycerides and low-density lipoproteins levels also occurred (p = 0.001). Conclusion. Leptin and IL-6 levels decrease and irisin and adiponectin levels increase correlating with a fat mass reduction and muscle mass expansion occurred with dapagliflozin added to the therapy. These findings suggest the possibility of metabolically unhealthy obesity transitioning to metabolically healthy obesity. Adipose tissue dysfunction treatment as a focus of therapy may provide not only a better control of T2DM, but also cardiometabolic risks reduction. Keywords: type 2 diabetes mellitus, dapagliflozin, adiponectin, leptin, irisin, interleukin 6, lipid panel, fat metabolism.