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. 2022 Sep 7;13(4):591–598. doi: 10.1007/s13340-022-00601-1

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© The Japan Diabetes Society 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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Fig. 2 — Healthy adipose expansion induced by a SGLT2 inhibitor. Possible mechanisms by which a SGLT2 inhibitor promote adipose expansion without deteriorating adipose inflammation, called as “healthy adipose expansion”. An SGLT2 inhibitor attenuates insulin resistance in adipose tissues. Restoring insulin action in adipose tissues inhibits adipocyte apoptosis, associated by increased capacity of lipid accumulation in adipocytes. When energy intake is enhanced by an SGLT2 inhibitor, it can be accumulated in adipocytes. Macrophage infiltration into adipose tissues is decreased probably due to decreased adipocytes apoptosis, resulting in decreased inflammatory cytokines from adipose tissues. Decreased adipose inflammation also attenuates insulin resistance in adipose tissues.