Dapagliflozin, metformin, or exercise didn't decrease plasma glucagon in individuals with prediabetes

Prediabetes is associated with an increased risk of developing type 2 diabetes and cardiovascular disease. Therefore, preventive initiatives aiming to reduce cardiometabolic risk in individuals with prediabetes are needed. It has been shown that lifestyle modification, weight loss, and metformin can reduce the risk of progression from prediabetes to type 2 diabetes.

Therefore, Kim KB Clemmensen and colleagues from the Steno Diabetes Center Copenhagen, Copenhagen, Denmark conducted the present study to To assess the effects of dapagliflozin, metformin and exercise treatment on changes in plasma glucagon concentrations in individuals with overweight and HbA1c-defined prediabetes.

The authors included a total of one-hundred and twenty individuals with overweight (body mass index ≥ 25 kg/m² ) and prediabetes (HbA1c of 39-47 mmol/mol), all of whom were randomized to a 13-week intervention with dapagliflozin (10 mg once daily), metformin (850 mg twice daily), exercise (30 minutes of interval training 5 days per week) or control (habitual living).

A 75-g oral glucose tolerance test (OGTT) (0, 30, 60, and 120 minutes) was administered at baseline, at 13 weeks (end of intervention), and at 26 weeks (end of follow-up). Linear mixed-effects models with participant-specific random intercepts were used to investigate associations of the interventions with fasting plasma glucagon concentration, insulin/glucagon ratio, and glucagon suppression during the OGTT.

The results observed were-

a. At baseline, the median age was 62 years, median fasting plasma glucagon concentration was 11 pmol/L, mean HbA1c was 40.9 mmol/mol and out of which 56% were women.

b. Compared with the control group, fasting glucagon did not change in any of the groups from baseline to the end of the intervention; exercise group: -8%; metformin group: -2%.

c. Likewise, there were no differences in insulin/glucagon ratio and glucagon suppression during the OGTT between the groups.

Hence, the authors further concluded that "in individuals with prediabetes, 13 weeks of treatment with dapagliflozin, metformin, or exercise was not associated with changes in fasting or post-OGTT glucagon concentrations."

For further reference log on to:

https://doi.org/10.1111/dom.14246