SGLT2-Inhibition Increases Hepatic Insulin Clearance (https://doi.org/10.1111/dom.13980)

Reduced hepatic insulin clearance (HIC) is a well-recognized consequence of obesity and hepatic fat accumulation in patients with type 2 diabetes. As part of a placebo-controlled 6-month trial of the SGLT2-inhibitor, tofogliflozin, Drs Matsubayashi & colleagues from Japan undertook meal tolerance tests to derive measurements of HIC. They showed significant increases in HIC among SGLT2-inhibitor treated patients, and the increases in HIC correlated with reductions in circulating triglyceride levels and increases in beta-hydroxybutyrate concentrations. Although the underlying mechanisms are not clear, this study provides evidence that SGLT2 inhibitor treatment increases HIC in patients with type 2 diabetes.