Evidence mapPaperPMID 24463448Full record

Trial reportThe Journal of clinical investigation2014

Dapagliflozin improves muscle insulin sensitivity but enhances endogenous glucose production.

Aurora Merovci, Carolina Solis-Herrera, Giuseppe Daniele, Roy Eldor, Teresa Vanessa Fiorentino, Devjit Tripathy, Juan Xiong, Zandra Perez, Luke Norton, Muhammad A Abdul-Ghani and 1 more

Erratum issued 4 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of clinical investigation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It reports registered trial NCT02113241. Cited by 387 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
387citing papers in PubMed, 3 pooled it
39.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02113241 phase2 / phase3completed

Effect of Dapagliflozin Administration on Metabolic Syndrome, Insulin Sensitivity, and Insulin Secretion

Ran2014Enrolled24Registered outcomes24Posted comparisons48ConditionsMetabolic Syndrome XArmsdapagliflozin, Placebo
Open the trial in the graph
NCT02613897 nacompletedstarted 2016, after this paper: background citation

A 16-wk, Uni-center, Randomized, Double-blind, Parallel, Phase 3b Trial to Evaluate Efficacy of Saxagliptin + Dapagliflozin vs.Dapagliflozin With Regard to EGP in T2DM With Insufficient Glycemic Control on Metformin+/-Sulfonylurea Therapy

Ran2016Enrolled56Registered outcomes9Posted comparisons0ConditionsDiabetes Mellitus, Type 2Armsdapagliflozin, Placebo, Saxagliptin
Open the trial in the graph
NCT02798744 phase4completedstarted 2016, after this paper: background citation

SGLT-2 Inhibitor Empagliflozin Effects on Appetite and Weight Regulation: A Randomised Double-blind Placebo-controlled Trial (The SEESAW Study)

Ran2016Enrolled68Registered outcomes15Posted comparisons0ConditionsDiabetes Mellitus, Type 2Armsdiet, empagliflozin, Placebo
Open the trial in the graph
NCT02304081 phase4completednot on this mapstarted 2015, after this paper: background citation

Effect of Saxagliptin in Addition to Dapagliflozin and Metformin on Insulin Resistance, Islet Cell Dysfunction, and Metabolic Control in Subjects With Type 2 Diabetes Mellitus on Previous Metformin Treatment

TypeinterventionalSponsorProf. Dr. Thomas ForstRan2015 to 2016Enrolled64ConditionsType2 Diabetes MellitusArmsSaxagliptin, Placebo for Saxagliptin
3 · Its place in the literature

Who cites it

387 citing papers in PubMed, 3 syntheses or guidelines pooled it, 771 citations in OpenAlex.

  1. Pooled it
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  7. Effects of SGLT2 inhibition on insulin use in CKD and type 2 diabetes: insights from the CREDENCE trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025 · on this map
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  9. Effects of the SGLT2 inhibitor dapagliflozin in early Alzheimer's disease: A randomized controlled trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
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327 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Aurora Merovci
Carolina Solis-Herrera
Giuseppe Daniele
Roy Eldor
Teresa Vanessa Fiorentino
Devjit Tripathy
Juan Xiong
Zandra Perez
Luke Norton
Muhammad A Abdul-Ghani
Ralph A DeFronzo
The University of Texas Health Science Center at San Antonio · US

Funding

SGLT2 Inhibitors, Ketogenesis, and KetoacidosisR01DK024092 · NIDDK · YALE UNIVERSITY · 1986 to 2025
$3.6M
NCATS NIH HHS KL2 TR001118NCATS NIH HHS UL1 TR001120NIDDK NIH HHS 5R01DK240923NIDDK NIH HHS R01 DK024092
6 · The paper itself

Abstract

Chronic hyperglycemia impairs insulin action, resulting in glucotoxicity, which can be ameliorated in animal models by inducing glucosuria with renal glucose transport inhibitors. Here, we examined whether reduction of plasma glucose with a sodium-glucose cotransporter 2 (SGLT2) inhibitor could improve insulin-mediated tissue glucose disposal in patients with type 2 diabetes. Eighteen diabetic men were randomized to receive either dapagliflozin (n = 12) or placebo (n = 6) for 2 weeks. We measured insulin-mediated whole body glucose uptake and endogenous glucose production (EGP) at baseline and 2 weeks after treatment using the euglycemic hyperinsulinemic clamp technique. Dapagliflozin treatment induced glucosuria and markedly lowered fasting plasma glucose. Insulin-mediated tissue glucose disposal increased by approximately 18% after 2 weeks of dapagliflozin treatment, while placebo-treated subjects had no change in insulin sensitivity. Surprisingly, following dapagliflozin treatment, EGP increased substantially and was accompanied by an increase in fasting plasma glucagon concentration. Together, our data indicate that reduction of plasma glucose with an agent that works specifically on the kidney to induce glucosuria improves muscle insulin sensitivity. However, glucosuria induction following SGLT2 inhibition is associated with a paradoxical increase in EGP. These results provide support for the glucotoxicity hypothesis, which suggests that chronic hyperglycemia impairs insulin action in individuals with type 2 diabetes.

Indexed as

Benzhydryl CompoundsBlood GlucoseBody WeightDiabetes Mellitus, Type 2FastingGlucagonGlucoseGlucose Clamp TechniqueGlucosidesHumansHyperglycemiaInsulinMaleMetforminMiddle AgedMusclesBenzhydryl CompoundsBlood GlucosedapagliflozinGlucagonGlucoseGlucosidesInsulinMetforminSLC5A2 protein, humanSodium-Glucose Transporter 2Sodium-Glucose Transporter 2 InhibitorsSulfonylurea Compounds

Identifiers

PMID24463448
PMCPMC3904617
OpenAlexW2166613497

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.