Thirty‐day dapagliflozin therapy improves the nanomechanical properties of red blood cells in patients with type 1 diabetes

BACKGROUND AND PURPOSE: Sodium-glucose cotransporter 2 (SGLT2) selective inhibitors (flozins) are a class of antidiabetic drugs that improve glycaemic control and are associated with cardiovascular benefits, although the underlying mechanisms remain incompletely understood. This study aimed to explore potential mechanistic effects of dapagliflozin on erythrocyte nanomechanical properties in patients with type 1 diabetes. EXPERIMENTAL APPROACH: The subject of this exploratory study is the nanomechanical properties of red blood cells (RBCs) in a pilot group of type 1 diabetes patients undergoing a thirty-day dapagliflozin treatment. Measurements were conducted on RBCs obtained from a homogeneous group of 31 adult patients with type 1 diabetes and 34 healthy control volunteers. The elastic modulus of erythrocytes was measured immediately after sample collection using the nanoindentation method with an atomic force microscopy probe. Data obtained before therapy (BT) and after therapy (AT) were compared with those from a control group of healthy volunteers. KEY RESULTS: A reduction in RBC stiffness after treatment was observed, which could be related to diabetes duration. Notably, the most significant improvement occurred in patients with diabetes duration exceeding 10 years, a group at elevated cardiovascular risk. Subgroup analyses were descriptive and not powered for inferential comparisons. CONCLUSION AND IMPLICATIONS: The observed improvement in the elastic modulus of erythrocytes following dapagliflozin therapy in patients with type 1 diabetes suggests that SGLT2 inhibitors could provide additional benefits for this patient group The results provide preliminary mechanistic insights that are consistent with the reported vascular effects of SGLT2 inhibitors.