Effect of dapagliflozin with and without acipimox on insulin sensitivity and insulin secretion in T2DM males

Aim: To investigate the effect of lowering the plasma glucose and free fatty acid (FFA) concentrations with dapagliflozin and acipimox, respectively, on insulin sensitivity and insulin secretion in T2DM individuals. Methods: Fourteen male T2DM patients received an oral glucose tolerance test and euglycemic hyperinsulinemic clamp at baseline and were treated for 3 weeks with dapagliflozin (10 mg per day). During week 3, acipimox (250 mg four times per day) treatment was added to dapagliflozin. The oral glucose tolerance test and insulin clamp were repeated at the end of weeks 2 and 3. Results: Dapagliflozin caused glucosuria and significantly lowered the plasma glucose concentration (by 35 mg/dL; P <.01), whereas the fasting plasma FFA concentration was unaffected. Acipimox caused a further decrease in the fasting plasma glucose concentration (by 20 mg/dL; P <.01) and a significant decrease in the fasting plasma FFA concentration. Compared to baseline, insulinmediated glucose disposal increased significantly at week 2 (from 4.48 = 0.50 to 5.30 = 0.50 mg/kg