# Changes in daily intake of nutrients and foods including confectionery after the initiation of empagliflozin in Japanese patients with type 2 diabetes: a pilot study

## TL;DR

This study found that Japanese type 2 diabetes patients eating more sweets after starting empagliflozin had lower blood sugar, but weight and other diet changes weren't linked to improvements.

## Contribution

The study is the first to show a link between early blood sugar reduction with empagliflozin and later increased confectionery intake in type 2 diabetes patients.

## Key findings

- After 24 weeks of empagliflozin treatment, confectionery intake increased while HbA1c improved and body weight decreased.
- A significant negative correlation was found between HbA1c reduction after 4 weeks and energy intake after 24 weeks.
- Principal component analysis linked early HbA1c changes to later energy intake and confectionery consumption.

## Abstract

It is unclear how dietary intake changes after sodium-glucose cotransporter 2 inhibitor (SGLT2i) treatment is started in patients with type 2 diabetes.

We performed a non-controlled, open-label study that enrolled 51 patients with type 2 diabetes. The patients were newly administered empagliflozin, and their dietary habits were examined using a self-administered diet history questionnaire at the beginning of the study and after 24 weeks. We investigated the association of changes in HbA1c and body weight with changes in energy, nutrient, and food group intakes.

At 24 weeks after the start of the study, HbA1c improved significantly and body weight decreased. In the food group, only the intake of confectionery increased, and there were no significant differences in the association between changes in HbA1c and body weight and changes in energy, nutrient, and food group intakes after 24 weeks. However, a significant negative correlation was found between change in HbA1c after 4 weeks and change in energy intake after 24 weeks, and principal component analysis showed an association between change in HbA1c levels after 4 weeks and change in energy intake and some food group intakes including confectionery after 24 weeks.

In this study, after 24 weeks of treatment with empagliflozin, only intake of confectionery increased. Early assessment by dietitians after initiation of SGLT2i treatment might be important because our data suggested that the reduction in blood glucose levels after the start of empagliflozin was associated with a subsequent increase in energy intake.

University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) on September 5, 2016 (registration ID, UMIN000002309|| http://www.umin.ac.jp/ctr/).

The online version contains supplementary material available at 10.1186/s40795-024-00902-5.