Can ipragliflozin treatment help lower insulin dose in patients with T2D receiving insulin therapy?

Can dapagliflozin help improve blood magnesium levels in patients with Type 2 diabetes?


Posted by Medivizor on Nov 6, 2019 in Diabetes mellitus |

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In a nutshell

This study examined the effects of dapagliflozin (Forxiga) on blood magnesium levels in patients with type 2 diabetes (T2D). The authors concluded that dapagliflozin treatment helped improve blood magnesium levels in these patients.

Some background

T2D is associated with a number of other health complications. Patients with T2D often have low magnesium levels in the blood (hypomagnesemia; HM). High blood glucose levels increase the loss of magnesium in the urine, which in turn lowers blood levels of magnesium. For patients with T2D, low magnesium levels increase the risk of kidney disease, heart disease, retinopathy, and foot ulcers.

Dapagliflozin is a sodium-glucose co-transporter 2 inhibitor (SGLT2 inhibitor). This type of drug helps the kidneys remove glucose from the body through the urine. This reduces blood glucose levels. Some studies suggest that SGLT2 inhibitors may improve HM. The effects of dapagliflozin treatment on magnesium levels in patients with T2D are under investigation.

Methods & findings

This study quantified blood magnesium levels from 10 trials that had compared dapagliflozin to placebo in patients with T2D. A total of 4398 patients were included. 2234 patients received dapagliflozin, and 2164 received a placebo (a substance with no active effect) for 24 weeks. Blood magnesium levels were measured at the start and end of the study.

At the beginning of the study, 17.6% of patients had HM. After 24 weeks of treatment, significantly more patients in the dapagliflozin group had normal magnesium levels compared to placebo (77.3% vs. 29.5%). Over the duration of the study, average blood magnesium levels significantly dropped by 0.06 mmol/L with dapagliflozin treatment compared to placebo.

Blood pressure is measured using systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dapagliflozin treatment decreased SBP by 3.02 mmHg and DBP by 1.33 mmHg compared to placebo. Heart rate also decreased by 0.75 beats per minute with dapagliflozin treatment compared to placebo.

Overall, slightly more patients in the dapagliflozin group experienced side effects compared to the placebo group (59.9% vs. 56.1%). Heart-related side effects were observed in 3.5% (dapagliflozin) and 3.8% (placebo) of patients.

The bottom line

The authors concluded that dapagliflozin helped improve blood magnesium levels in patients with T2D. Dapagliflozin treatment did not increase the risk of high magnesium levels.

The fine print

The manufacturer of dapagliflozin, AstraZeneca, funded this study. Also, more patients who received dapagliflozin had normal magnesium levels compared to patients who received a placebo. Some patients in this study also received other treatments in addition to dapagliflozin. More studies are needed to confirm these results.

What’s next?

Talk to your doctor about how to improve or prevent low blood magnesium levels.

Published By :

Journal of Diabetes and its Complications

Original Title :

Correction of hypomagnesemia by dapagliflozin in patients with type 2 diabetes: A post hoc analysis of 10 randomized, placebo-controlled trials.

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