The Effect of SGLT-2 Inhibitors on Serum Potassium and Serum Sodium Levels in Diabetic Patients taking SGLT-2 Inhibitors, Reporting in A Tertiary Care Hospital, Rawalpindi
DOI:
https://doi.org/10.51253/pafmj.v75i1.11954Keywords:
Dapagliflozin, Empagliflozin, Endocrinology, SGLT2 inhibitors, serum potassium and sodium levels, Type 2 diabetes.Abstract
Objective: To evaluate how SGLT2 inhibitors, in comparison to a placebo and the maximum dose of Metformin, affect the levels of serum potassium and sodium in individuals with Type II Diabetes.
Study Design: Quasi- Experimental study
Place and Duration of Study: Department of Medicine (Endocrinology) in a tertiary care hospital, in Rawalpindi Pakistan from Oct 2022 to Mar 2023.
Methodology: A total of 200 patients with type II diabetes were recruited and divided into two groups. 100 diabetic patients were placed in Group-A and were given SGLT-2 inhibitors (Dapagliflozin and Empagliflozin) while 100 diabetic patients were placed in Group-B, given a placebo in addition to a maximum dose of 2000mg/day of Metformin they were already taking. Patients were observed over 24 weeks and the levels of serum potassium and sodium were assessed at the end of this period.
Results: Mean sodium levels of patients receiving SGLT-2 inhibitors were 139.3±3.18 mmol/L while of those who received placebo were 138.94±3.5 mmol/L with a p-value of 0.44. The mean potassium levels of patients who received SGLT-2 inhibitors were 3.96±0.33 mmol/L while of those who received placebo were 3.97±0.38 mmol/L with a p-value of 0.8. There was statistically no difference in serum sodium and potassium levels of the two groups.
Conclusion: SGLT-2 inhibitors (Dapagliflozin and Empagliflozin) do not affect serum sodium and potassium levels when compared to patients who were given placebo as there was statistically no significant difference among the two groups.
Downloads
References
Britannica, T. Editors of Encyclopaedia (2023, December 5). diabetes mellitus. Encyclopedia Britannica. In.
He S, Wang J, Zhang X, Qian X, Yan S, Wang W, et al. Long-term influence of type 2 diabetes and metabolic syndrome on all-cause and cardiovascular death, and microvascular and macrovascular complications in Chinese adults — a 30-year follow-up of the Da Qing Diabetes Study. Diabetes Res Clin Practice. 2022; 191: 110048. https://doi:10.1016/j.diabres.2022.110048
Dahlén AD, Dashi G, Maslov I, Attwood MM, Jonsson J, Trukhan V, et al. Trends in Antidiabetic Drug Discovery: FDA approved drugs, new drugs in clinical trials and global sales. Frontiers Pharmacol. 2022; 12. https://doi:10.3389/fphar.2021.807548
Saponaro C, Mühlemann M, Acosta-Montalvo A, Piron A, Gmyr V, Delalleau N, et al. Interindividual heterogeneity of SGLT2 expression and function in human pancreatic islets. Diabetes. 2020; 69(5): 902–914. https://doi:10.2337/db19-0888
DeFronzo R, Reeves W, Awad A. Pathophysiology of diabetic kidney disease: Impact of SGLT2 inhibitors. Nat Rev Nephrol. 2021; 17(5): 319–334. https://doi:10.1038/s41581-021-00393-8
Fioretto P, Stefansson B, Johnsson E, Cain V, Sjöström C. Dapagliflozin reduces albuminuria over 2 years in patients with type 2 diabetes mellitus and renal impairment. Diabetologia. 2016; 59(9): 2036–2039. https://doi:10.1007/s00125-016-4017-1
Yavin Y, Mansfield TA, Ptaszynska A, Johnsson K, Parikh S, Johnsson E. Effect of the SGLT2 inhibitor dapagliflozin on potassium levels in patients with type 2 diabetes mellitus: A pooled analysis. Diabetes Ther. 2016;7(1):125–137.
https://doi:10.1007/s13300-015-0150-y
Cianciolo G, De Pascalis A, Gasperoni L, Tondolo F, Zappulo F, Capelli I, et al. The off-target effects, electrolyte and mineral disorders of SGLT2i. Molecules. 2020; 25(12): 2757.
https://doi:10.3390/molecules25122757
Zhang J, Huan Y, Leibensperger M, Seo B, Song Y. Comparative effects of sodium-glucose cotransporter 2 inhibitors on serum electrolyte levels in patients with type 2 diabetes: A pairwise and network meta-analysis of randomized controlled trials. Kidney360. 2022; 3(3): 477–487. https://doi:10.34067/kid.0006672021
Weir M, Slee A, Sun T, Balis D, Oh R, de Zeeuw D, et al. Effects of canagliflozin on serum potassium in the Canagliflozin Cardiovascular Assessment Study (CANVAS) program. Clin Kidney J. 2020; 14(5): 1396–1402. https://doi:10.1093/ckj/sfaa133
Abdul-Ghani M, Del Prato S, Chilton R, DeFronzo RA. SGLT2 inhibitors and cardiovascular risk: Lessons learned from the Empa-Reg Outcome Study. Diabetes Care. 2016; 39(5): 717–725.
https://doi:10.2337/dc16-0041
Monnerat S, Atila C, Refardt J, Christ-Crain M. Prevalence of admission hyponatremia in patients with diabetes treated with and without an SGLT2 inhibitor. J Endocr Soc. 2023; 7(4)bvad011. https://doi:10.1210/jendso/bvad011
Cianciolo G, De Pascalis A, Gasperoni L, Tondolo F, Zappulo F, Capelli I, et al. The off-target effects, electrolyte and mineral disorders of SGLT2i. Molecules. 2020; 25(12): 2757.
https://doi:10.3390/molecules25122757
Bailey C, Day C. SGLT2 inhibitors: Glucuretic treatment for type 2 diabetes. British J Diabetes Vas Dis. 2010; 10(4): 193–199.https://doi:10.1177/1474651410377832
Invokana, (canagliflozin) HCP [Internet]. Available at https://www.invokanahcp.com/[accessed on Mar 22,2024]
Refardt J, Imber C, Sailer C, Jeanloz N, Potasso L, Kutz A, et al. A randomized trial of empagliflozin to increase plasma sodium levels in patients with the syndrome of inappropriate antidiuresis. J Am Soc Nephrol. 2020; 31(3): 615-624.
https://doi.org/10.1681/asn.2019090944
Zinman B, Wanner C, Lachin J, Fitchett D, Bluhmki E, Hantel S,et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015; 373(22): 2117-2128.
https://doi.org/10.1056/nejmoa1504720
Heerspink H, Stefánsson B, Correa-Rotter R, Chertow G, Greene T, Hou F, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020; 383(15): 1436-1446.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Abdul Latif Khattak, Ahmar Rashid, Farah Javed, Sana Aziz, Fuad Ahmad Siddiqi, Syeda Alihah
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
