Tofogliflozin most effective with high baseline insulin

(HealthDay)—The sodium glucose co-transporter 2 inhibitor tofogliflozin is effective for reducing fasting plasma glucose and body weight, particularly in patients with a high insulin level at baseline, according to a study published online Oct. 15 in the Journal of Diabetes Investigation.

Kazuyuki Tobe, M.D., Ph.D., from the University of Toyama in Japan, and colleagues conducted a sub-analysis of a multicenter, open-label, 52-week, randomized controlled trial of
tofogliflozin as monotherapy in Japanese patients with type 2 diabetes mellitus. Patients were categorized into tertiles by baseline insulin level: low (L) insulin (≤5.6 µU/mL), medium (M) insulin (5.6 to 10µU/mL), and high (H) insulin (>10µU/mL).

The researchers found that HbA1c, fasting plasma glucose levels, and body weight were significantly reduced from the baseline in all three groups. The changes in levels of plasma glucose AUC_{0-2 hours}, C-peptide index AUC_{0-2 hours} during the meal tolerance tests, and the insulin secretion index were the largest in the H group. The three groups were similar in terms of incidence of drug-related adverse events.

"Although tofogliflozin was effective regardless of baseline insulin level, it showed the highest efficacy in the H group," conclude the authors.

The authors disclosed financial ties to the pharmaceutical industry. Chugai Pharmaceutical Co. funded the original phase 3 trial.