How a diabetes pill affects ketones and the risk of ketoacidosis

SGLT2 Inhibitors, Ketogenesis, and Ketoacidosis

NIH-funded research University of Texas Hlth Science Center · NIH-11137783

Researchers will look at how the diabetes medicine empagliflozin changes ketone production and liver glucose release in adults with diabetes and whether adding pioglitazone can prevent those effects.

Quick facts

Grant typeR01 grant
Study typeNIH-funded research
Funding institutionUniversity of Texas Hlth Science Center NIH-funded
Lab location1 site (San Antonio, United States)
Project IDNIH-11137783 on NIH RePORTER

What this research studies

If you take part, you'll receive empagliflozin and have blood tests that measure ketone levels and how much glucose your liver makes using safe isotope tracers. The team will run several short inpatient or outpatient protocols to track changes in ketones and hepatic glucose production over time. In later parts, participants may also receive pioglitazone to see if it prevents the rise in ketones and liver glucose output caused by empagliflozin. Visits will include blood draws, medication dosing, and monitoring for any signs of ketoacidosis.

Who could benefit from this research

Good fit: Adults with type 1 or type 2 diabetes who are willing to take empagliflozin (and possibly pioglitazone), undergo blood draws, and attend study visits at the clinical site would be ideal candidates.

Not a fit: People without diabetes, pregnant individuals, those with severe kidney disease, or those unwilling to undergo frequent blood testing and clinic visits are unlikely to benefit or be eligible.

Why it matters

Potential benefit: This work could make SGLT2 inhibitor treatment safer by reducing the risk of ketoacidosis and allow more people with diabetes to benefit from these drugs.

How similar studies have performed: SGLT2 inhibitors already show clear heart and kidney benefits, but using isotope tracer techniques to pinpoint why they raise ketones and testing whether pioglitazone blocks that effect is a relatively new and more detailed approach.

Where this research is happening

San Antonio, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Conditions Adult-Onset Diabetes MellitusAtherosclerotic Cardiovascular DiseaseBrittle Diabetes Mellitus
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.