Intervention and control
hypoglycemia, hypoglycemic, hypotension
HYPOGLYCEMIA
Eligible participants will be randomly assigned (1:1) to the canagliflozin or control group. After a run-in period of up to 4–8 weeks, the canagliflozin group patients will be administered canagliflozin 100 mg orally once daily in the morning for 12 weeks. In contrast, in the control group, glucose levels will be controlled without any SGLT2i. Inulin and para-aminohippuric acid (PAH) clearance tests for the measurement of renal hemodynamics will be performed at baseline and 4 weeks after the start of the trial. A change in the type or dose of prior diabetic drugs and antihypertensive drugs is prohibited during the 12-week intervention period, but if side effects such as hypoglycemia and hypotension occur, reduction of the dose or discontinuation of these drugs is allowed. The use of the following drugs is restricted during the 12-week intervention period: diuretics, drugs that enhance the hypoglycemic effect, including β-blockers, salicylic acid agents, and monoamine oxidase inhibitors.The study flowchart is shown in Fig. The study flowchart