The type 2 diabetes drug canagliflozin has been shown to reduce adipose (fat) tissue function, independent of weight loss, when compared to glimepiride treatment, new research suggests.
Adipose tissue acts as an insulating layer under the skin, helping to support major organs such as the kidneys and help with energy storages. But the normal function of adipose tissue is impaired in obesity, which is a significant risk factor for type 2 diabetes.

Scientists from the University of Alabama found that canagliflozin (marketed as Invokana), an SGLT2 inhibitor, had a big impact on the metabolism, including changes in energy balance.
They analysed samples from 100 adults with type 2 diabetes who received 300mg daily canagliflozin for 52 weeks and monitored its effects on adipose tissue function, as well as HbA1c levels and body weight.
They also evaluated a separate cohort of 100 adults with type 2 diabetes treated with glimepiride (marketed as Amaryl), a sulphonylurea.
Canagliflozin treatment led to greater reductions in body weight and HbA1c levels compared to glimepiride at the end of the 52 weeks.
Canagliflozin was shown to inhibit a co-transporter of the kidney that led to metabolic improvements in the participants, including decreases in a hormone called lepti, which works to inhibit hunger.
This change in leptin levels was found to correlate to greater body weight reductions, but the researchers found that changes in two other hormones, adiponectin and IL-6, were not linked to changes in HbA1c or body weight.
“We conclude that these collective results suggest that canagliflozin may improve adipose tissue function, increasing adiponectin and decreasing the inflammatory posture of the adipocytes as reflected by a decrease in IL-6, independent of weight loss, and these may reflect favourably on cardiometabolic health,” said lead author W. Timothy Garvey, MD.
Garvey presented the findings at the American Association of Clinical Endocrinologists Annual Scientific and Clinical Congress. He added that the direct effects of canagliflozin on cardiovascular outcomes will be revealed in June following the completion of the ongoing CANVAS study.

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