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Publication : SGLT2 deletion improves glucose homeostasis and preserves pancreatic beta-cell function.

First Author  Jurczak MJ Year  2011
Journal  Diabetes Volume  60
Issue  3 Pages  890-8
PubMed ID  21357472 Mgi Jnum  J:169747
Mgi Id  MGI:4942200 Doi  10.2337/db10-1328
Citation  Jurczak MJ, et al. (2011) SGLT2 Deletion Improves Glucose Homeostasis and Preserves Pancreatic {beta}-Cell Function. Diabetes 60(3):890-8
abstractText  OBJECTIVE Inhibition of the Na(+)-glucose cotransporter type 2 (SGLT2) is currently being pursued as an insulin-independent treatment for diabetes; however, the behavioral and metabolic consequences of SGLT2 deletion are unknown. Here, we used a SGLT2 knockout mouse to investigate the effect of increased renal glucose excretion on glucose homeostasis, insulin sensitivity, and pancreatic beta-cell function. RESEARCH DESIGN AND METHODS SGLT2 knockout mice were fed regular chow or a high-fat diet (HFD) for 4 weeks, or backcrossed onto the db/db background. The analysis used metabolic cages, glucose tolerance tests, euglycemic and hyperglycemic clamps, as well as isolated islet and perifusion studies. RESULTS SGLT2 deletion resulted in a threefold increase in urine output and a 500-fold increase in glucosuria, as well as compensatory increases in feeding, drinking, and activity. SGLT2 knockout mice were protected from HFD-induced hyperglycemia and glucose intolerance and had reduced plasma insulin concentrations compared with controls. On the db/db background, SGLT2 deletion prevented fasting hyperglycemia, and plasma insulin levels were also dramatically improved. Strikingly, prevention of hyperglycemia by SGLT2 knockout in db/db mice preserved pancreatic beta-cell function in vivo, which was associated with a 60% increase in beta-cell mass and reduced incidence of beta-cell death. CONCLUSIONS Prevention of renal glucose reabsorption by SGLT2 deletion reduced HFD- and obesity-associated hyperglycemia, improved glucose intolerance, and increased glucose-stimulated insulin secretion in vivo. Taken together, these data support SGLT2 inhibition as a viable insulin-independent treatment of type 2 diabetes.
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