Effect of Dapagliflozin on Serum Uric Acid in Type 2 Diabetes Mellitus patients

Abstract

Diabetes is one of the most common metabolic diseases, linked to hyperuricemia. Several studies have shown that high serum uric acid levels (SUA) are associated with an increased risk of diabetes. SGLT2 inhibitors (Sodium Glucose Cotransporter-2 Inhibitors) are a new drug for diabetes treatment. In addition to their ability to lower blood glucose, they have other benefits, including lowering serum uric acid levels. This study aimed to evaluate the effect of dapagliflozin, which is a selective inhibitor of SGLT2 Cotransporters present in the kidneys, on serum uric acid levels in patients with type 2 diabetes, compared with a control group. The study included 51 patients with type 2 diabetes, randomly selected from an endocrinology clinic, who started dapagliflozin treatment 5 and 10 mg at recruitment. The control group included 64 patients with type 2 diabetes treated with metformin. Patients were monitored for 3-6 months and serum uric acid levels were measured at baseline and after follow-up. 3 months after treatment, the mean concentration of uric acid in the dapagliflozin group was lower than that of the metformin group (4.58 vs. 5.24 mg/dl p = 0.0143). At 6 months follow-up, SUA levels decreased by 0.79 mg/dL and it was statistically significant (p = 0.0004), compared with control group where there was no statistically significant change in SUA levels. Statistically, there was no significant difference in uric acid levels between doses 5 and 10 mg. However, decreasing in SUA levels with dapagliflozin 5 mg was greater than that occurred with dapagliflozin 10 mg after 6 months of treatment. In conclusion, Dapagliflozin results in a decrease of SUA levels in patients with type 2 diabetes by increasing urinary excretion of uric acid induced by SGLT2 inhibitors.