SAT-591 Effect of Sglt2 inhibitors on Renin Angiotensin system in Type 2 Diabetes

Abstract Disclosure: S. Kotla: None. Introduction: SGLT2i might have an interfering effect on plasma renin concentration and plasma aldosterone levels, due to their diuretic and sympathoinhibition effects. Objective of the study: To study the effect of sglt2 inhibitors on Renin Angiotensin sytem in Type 2 Diabetes patients. Materials and methods: A one year hospital based prospective observational study from January 2023 to June 2024 was done in patients with type 2 diabetes > 18 yrs who were started on sglt2 inhibitors. Exclusion criteria: Pregnancy & lactation, CKD patients ≥ stage 2, Hypertensive patients & Patients on Betablockers, ACE Inhibitors, ARBs & Diuretics. Patients were evaluated for Direct renin concentration and Plasma aldosterone levels at baseline and after 3 months and 6 months of sglt2 inhibitors and changes were analysed. Results: Study included 82 patients who were started on sglt2 inhibitors, Baseline characteristics were: Mean age: 51.53 ± 9.67 years (range 33 to 75 yrs), 59% patients were male, Mean HbA1c: 9.23 ± 2.02% (range 6.2 to 14.6%) at baseline. At baseline Mean Plasma Aldosterone concentration (PAC) 13.37 ± 8.18 ng/dl and Direct Renin Concentration (DRC) was 22.90 ±40.35 mIU/ml. After 3 months of treatment with sglt2 inhibitors mean PAC was 14.37±40.37 ng/dl, mean DRC was 22.76 ± 43.06 mIU/ml. After 6 months mean DRC was 21.9±44.32, mean PAC was 13.02±10.32. There was no statistically significant change in levels of Renin and Aldosterone after 3 months and 6 months. Conclusion: Chronic use of SGLT2 inhibitors does not cause activation of RAAS (Renin-Angiotensin-Aldosterone System). The absence of sustained RAAS activation by SGLT2 inhibitors may be a key mechanism contributing to their cardioprotective and renoprotective effects. This is particularly significant in Type 2 Diabetes, where RAAS overactivation is associated with negative cardiovascular and renal outcomes. Presentation: Saturday, July 12, 2025