As-required administration of sodium glucose co-transporter-2 inhibitors: three case studies

Sodium glucose co-transporter-2 (SGLT2) inhibitors are used to reduce glycated hemoglobin (HbA1c) levels. Although they have the potential to reduce body weight in patients with type 2 diabetes mellitus (T2DM), some patients may gain weight. We found that the effects of the SGLT2 inhibitor ipragliflozin were maintained for 48 h when used in combination with nifedipine, so we considered that a daily SGLT2 inhibitor might be unnecessary. Therefore, we investigated whether as-required single doses of an SGLT2 inhibitor would be clinically relevant in three patients having difficulty maintaining blood glucose control when they were unable to exercise or during social situations. All three patients demonstrated improved HbA1c levels with as-required single doses of an SGLT2 inhibitor. These patients experienced no adverse effects or weight gain relative to taking an SGLT2 inhibitor daily. Thus, as-required single-dose SGLT2 inhibitors could be one of the many options to improve blood glucose control in T2DM.