Schork A, et al. - In this longitudinal observational study, researchers explored the impact of sodium-coupled glucose transporter 2 (SGLT2)-inhibitors on body composition, fluid status and renin-angiotensin-aldosterone system in patients with type 2 diabetes mellitus. Participants were 27 outpatients with type 2 diabetes mellitus, including 18 on empagliflozin and 9 on dapagliflozin. Using bioimpedance spectroscopy (BCM, Fresenius), body composition of these patients was assessed during the first week and up to 6 months following start of therapy with SGLT2-inhibitors. They compared fluid status with that of 14 hypertensive patients on hydrochlorothiazide and 16 healthy persons. In association with treatment with SGLT2-inhibitors, body weight reduction was noted, which was induced by reducing adipose tissue mass and transient loss of extracellular fluid accompanied by upregulation of renin-angiotensin-aldosterone system (RAAS). Under SGLT2 inhibition, there is no permanent loss of extracellular water.