Use of Sodium Glucose Cotransporter-2 Inhibitor and Thiol Disulfide Homeostasis in Type -2 Diabetic Patients

Abstract

To investigate the presence of antioxidant activity in sodium glucose cotransporter-2 inhibitors (SGLT-2I), which have a preventive effect on the progression of complications since reactive oxygen species damage has a major effect on diabetes morbidity and mortality. Thiol, disulfide and ischemia-modified albumin levels were measured in the blood of type 2 diabetes mellitus (DM) patients who were using SGLT-2I for at least one year and those who were not using this drug. Data of 53 patients using SGLT-2I and 62 patients not using SGLT-2I were analyzed. Gender and age were similar in the two groups (p: 0.293, 0.772, respectively). DM duration, HbA1c level and number of drug types used in the combination were higher in the SGLT-2I group (p: 0.003, <0.001, and <0.001, respectively). Disulfide/native thiol was significantly higher in the SGLT-2I group (4.29±1.65 vs 4.06±1.99, p: 0.038). In the analyses of the groups under 50 years of age, female gender, HbA1c≥7%, no complications and concomitant use of dipeptidyl peptidase-4 inhibitor (DPP-4I), the disulfide/native thiol ratio was significantly higher in SGLT-2I users than in non-users (p: 0.072, 0.021, 0.040, 0.008 and 0.032, respectively). In the analysis of patients with DM duration of less than 10 years, the disulfide/native thiol ratio in the SGLT-2I group was significantly higher than those who did not use the drug (p:0.048). Native thi ols were statistically similar in all group analyses (p>0.05). Again, IMA was similar in all group analyses (p>0.05) SGLT-2I use affects thiol disulfide homeostasis more especially in those younger than 50 years, with diabetes duration <10 years, without complications, HbA1c≥7% and using DPP-4I together. The fact that no decrease was detected in native thiol suggests that this effect is more in the antioxidant direction. © 2025 Elsevier B.V., All rights reserved.