A new clinical study analyzed how long-term use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) affects body composition in people with type 2 diabetes (T2D). The findings were published in Journal of Diabetes and Its Complications.

The retrospective cohort study followed 70 individuals with T2D who had been on SGLT2i therapy for more than two years. Researchers evaluated changes in body mass index (BMI), body fat percentage, skeletal muscle mass, and skeletal muscle mass index (SMI) over an average treatment period of 4.4 years. Body composition was evaluated through bioelectrical impedance analysis (BIA) at three time points, i.e., before starting SGLT2i therapy, one year after initiation, and at the most recent follow-up.

The study found that SGLT2i therapy led to a significant reduction in BMI, which declined from an average of 30.5 to 29.1 (p < 0.0001). Skeletal muscle mass also decreased significantly, from 30.3 kg to 29.0 kg (p < 0.0001). The decrease in BMI was closely correlated with reductions in both body fat percentage and skeletal muscle mass (all p < 0.0001).

Age-stratified analysis showed differing effects by age. Reduction in skeletal muscle mass among younger patients was significantly related to both treatment duration and BMI reduction.

However, the correlation between muscle mass decline and BMI change was weaker in older adults. These older individuals experienced muscle mass reduction earlier during treatment, pointing to a greater vulnerability to sarcopenia.