A 53-year-old man arrives at the office with uncontrolled type 2 diabetes. The patient was diagnosed with diabetes three years ago and started on metformin and lifestyle changes. His hemoglobin A1c level has been steadily rising over the last year. The reading is 145/90 mm Hg. The BMI is 37 kg/m2². Except for a fasting plasma glucose of 155 mg/dL and a hemoglobin A1c level of 8%, the laboratory results are normal. Additional treatment with canagliflozin is initiated. Over the next several days, which of the following changes are most likely to occur in this patient due to the new medication?

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Eductional Objective: Inhibitors of sodium-glucose cotransporter 2 reduce renal reabsorption of glucose and sodium, resulting in increased urinary glucose excretion and lower blood glucose levels. Furthermore, natriuresis and osmotic diuresis reduce extracellular fluid volume, total body sodium content, and blood pressure.

A 53-Year-Old Man Arrives at the Office with Uncontrolled Type