Utilizing machine learning algorithms for precise discrimination of glycosuria in fluorescence spectroscopic data.

Fluorescence spectroscopy coupled with a random forest machine learning algorithm offers a promising non-invasive approach for diagnosing glycosuria, a condition characterized by excess sugar in the urine of diabetic patients. This study investigated the ability of this method to differentiate between diabetic and healthy control urine samples. Fluorescent spectra were captured from urine samples using a Xenon arc lamp emitting light within the 200 to 950 nm wavelength range, with consistent fluorescence emission observed at 450 nm under an excitation wavelength of 370 nm. Healthy control samples were also analyzed within the same spectral range for comparison. To distinguish spectral differences between healthy and infected samples, the random forest (RF) and K-Nearest Neighbors (KNN) machine learning algorithms have been employed. These algorithms automatically recognize spectral patterns associated with diabetes, enabling the prediction of unknown classifications based on established samples. Principal component analysis (PCA) was utilized for dimensionality reduction before feeding the data to RF and KNN for classification. The model's classification performance was evaluated using 10-fold cross-validation, resulting in the proposed RF-based model achieving accuracy of 96 %, specificity of 100 %, sensitivity of 93 %, and precision of 100 %. These results suggest that the proposed method holds promise for a more convenient and potentially more accurate method for diagnosing glycosuria in diabetic patients.

Portable, quantitative, and sequential monitoring of copper ions and pyrophosphate based on a DNAzyme-Fe3O4 nanosystem and glucometer readout.

In this report, portable, quantitative, and sequential monitoring of copper ions and pyrophosphate (PPi) with a single sensor based on a DNAzyme-Fe3O4 system and glucometer readout was performed. Initially, streptavidin was functionalized on the surface of magnetic Fe3O4 spheres through glutaraldehyde. Then, an invertase-modified DNA Cu substrate was connected to the magnetic Fe3O4 spheres by a specific reaction between streptavidin and biotin. The sensing system was formed by a hybridization reaction between the Cu substrate and Cu enzyme. In the presence of Cu2+, Cu2+ will recognize the Cu DNA substrate and form an "off-on" signal switch, thereby resulting in the separation of invertase from the Fe3O4 nanospheres. PPi recognizes Cu2+ to form a Cu2+-PPi complex, resulting in an "on-off" signal switch. Under optimized conditions, linear detection ranges for Cu2+ and PPi of 0.01-5 and 0.5-10 µM, and detection limits for Cu2+ and PPi of 10 nM and 500 nM, respectively, were obtained. Good selectivity was achieved for the analysis of Cu2+ and PPi. Satisfactory results were achieved for this biosensor during the determination of Cu2+ in real tap samples and PPi in human urine samples. This verified that the sensor is portable and low cost, and can be applied to the sequential monitoring of multiple analytes with a single point-of-care biosensor.

Lipid Accumulation Product Combined With Urine Glucose Excretion Improves the Efficiency of Diabetes Screening in Chinese Adults.

Background: To compare the efficacy of lipid accumulation product (LAP) and urine glucose excretion (UGE) in predicting diabetes and evaluate whether the combination of LAP and UGE would help to improve the efficacy of using LAP alone or UGE alone in identifying diabetes. Methods: Data from 7485 individuals without prior history of diabetes who participated in a cross-sectional survey in Jiangsu, China, were analyzed. Each participant underwent an oral glucose-tolerance test. Operating characteristic curves (ROC) and logistic regression analyses were used to evaluate the performance of LAP and UGE in identification of newly diagnosed diabetes (NDM) and prediabetes (PDM). Results: For subjects with NDM, the area under the ROC curve was 0.72 for LAP and 0.85 for UGE, whereas for PDM, these values were 0.62 and 0.61, respectively. Furthermore, LAP exhibited a comparable sensitivity with UGE in detecting NDM (76.4% vs 76.2%, p = 0.31). In predicting PDM, LAP showed a higher sensitivity than UGE (66.4% vs 42.8%, p < 0.05). The combination of LAP and UGE demonstrated a significantly higher sensitivity than that of LAP alone and UGE alone for identification of NDM (93.6%) and PDM (80.1%). Moreover, individuals with both high LAP and high UGE had significantly increased risk of NDM and PDM than those with both low LAP and low UGE. Conclusions: The combination of LAP and UGE substantially improved the efficacy of using LAP and using UGE alone in detecting diabetes, and may be a novel approach for mass screening in the general population.

Mass urine sugar testing to tackle post-COVID mucormycosis epidemic in India-MUSTARD concept.

BACKGROUND: Post-Covid mucormycosis is associated with very high morbidity and reasonably high mortality. The three main causes seem to be covid infection, excessive steroid usage and uncontrolled diabetes. METHODS: Of the three risk factors causing post-Covid mucormycosis, the only risk factor which can be modified quickly is uncontrolled diabetes. Checking urine-sugar levels of susceptible population asymptomatic for mucormycosis can be done rapidly and at a relatively low cost. Urine sugar positive persons can then be investigated and managed for uncontrolled diabetes. RESULTS: None CONCLUSIONS: Mass urine sugar testing to assess and regulate diabetes(MUSTARD) can help identify and manage uncontrolled diabetes in populations with high prevalence of diabetes.

CRISPRi-Mediated NIMPLY Logic Gate for Fine-Tuning the Whole-Cell Sensing toward Simple Urine Glucose Detection.

Whole-cell biosensors have been regarded as a prominent alternative to chemical and physical biosensors due to their renewability, environmental friendliness, and biocompatibility. However, there is still a lack of noninvasive measurements of urine glucose, which plays a vital role in monitoring the risk of diabetes in the healthcare system, via whole-cell biosensors. In this study, we characterized a glucose-inducible promoter and further enhanced the sensing performance using three genetic effectors, which encompassed ribozyme regulator (RiboJ), clustered regularly interspaced short palindromic repeat interference (CRISPRi), and plasmid-based T7RNA polymerase (PDT7), to develop the noninvasive glucose biosensor by fluorescent signal. As a result, RiboJ increased dynamic range to 2989 au, but declined signal-to-noise (S/N) to 1.59, while CRISPRi-mediated NIMPLY gate intensified both dynamic range to 5720 au and S/N to 4.58. The use of single PDT7 orthogonal with T7 promoter in cells (i.e., P strain) achieved a 44 180 au of dynamic range with S/N at 3.08. By coupling the PDT7 and NIMPLY-mediated CRISPRi, we constructed an optimum PIGAS strain with the highest S/N value of 4.95. Finally, we adopted the synthetic bacteria into a microdevice to afford an integrative and portable system for daily urine glucose inspection, which would be an alternative approach for medical diagnosis in the future.

Green synthesis of platinum nanoclusters using lentinan for sensitively colorimetric detection of glucose.

The sensitive colorimetric detection of glucose using nanomaterials has been attracting considerable attention. To improve the detection sensitivity, highly stable lentinan stabilized platinum nanoclusters (Pt-LNT NCs) were prepared, in which lentinan was employed as a mild reductant and stabilizer. The size of platinum nanoclusters (Pt NCs) was only 1.20 ± 0.29 nm. Pt-LNT NCs catalyzed the oxidation of substrate 3,3',5,5'-tetramethylbenzidine (TMB) in the presence of hydrogen peroxide (H2O2) to produce a blue oxidation product with absorption peak at 652 nm, indicating their peroxidase-like properties. Their enzymatic kinetics followed typical Michaelis-Menten theory. In addition, fluorescence experiments confirmed their ability to efficiently catalyze the decomposition of H2O2 to generate •OH, which resulted in the peroxidase-like mechanism of Pt-LNT NCs. Moreover, a colorimetric method for highly selective and sensitive detection of glucose was established by using Pt-LNT NCs and glucose oxidase. The linear range of glucose detection was 5-1000 µM and the detection limit was 1.79 µM. Finally, this method was further used for detection of glucose in human serum and human urine. The established colorimetric method may promote the development of biological detection and environmental chemistry in the future.

High urinary glucose is associated with improved renal prognosis in patients with diabetes mellitus.

AIMS/INTRODUCTION: The relationship between renal function and urinary glucose is poorly understood in diabetes patients who are not using sodium-glucose cotransporter 2 inhibitors. This study aimed to investigate the association of urinary glucose excretion with renal function prognosis in such patients. MATERIALS AND METHODS: This retrospective cohort study included 1,172 patients with type 1 or 2 diabetes mellitus. Patients were recruited and data were collected between 1 January 2007 and 31 December 2011; follow-up data were collected until 30 June 2015. The primary outcome was set as a 30% decline in estimated glomerular filtration rate relative to baseline. The relationship between this outcome and urinary glucose was investigated using Cox proportional hazards model. For analysis, patients were categorized into two groups: urinary glucose <5 g/day or ≥5 g/day. Interaction terms were analyzed. RESULTS: Multivariate analysis showed that the prognosis of renal function was significantly better in patients with high urinary glucose (≥5 g/day; adjusted hazard ratio 0.58, 95% confidence interval 0.35-0.96; P = 0.034). Significant interactions were observed between high urinary glucose and male sex (hazard ratio 0.33, 95% confidence interval 0.14-0.74; P = 0.007), and between high urinary glucose and longer duration of diabetes (≥10 years; hazard ratio 0.25, 95% confidence interval 0.11-0.58; P = 0.001). CONCLUSIONS: The present study suggests that high urinary glucose is associated with prognosis in diabetes patients not taking sodium-glucose cotransporter 2 inhibitors. Measurement of 24-h urinary glucose excretion might have clinical utility for predicting renal prognosis.

Urine glucose concentration: A useful parameter as a surrogate for glycaemia on the first day of life in canine neonates.

INTRODUCTION: Hypoglycaemia is a well-known risk factor in neonatal puppies and kittens; glycaemia control is crucial during the first days of life. Kidneys immaturity provokes the presence of physiological glycosuria during the first 2-3 weeks of life in small animals. OBJECTIVES: The aim of this study was to evaluate the potential of glycosuria as a predictor of glycaemia in neonatal puppies during the first two weeks of life. METHODS: Prospective study. Thirty-three client-owned healthy neonatal puppies admitted to the Veterinary Teaching Hospital, Autonomous University of Barcelona, were included in the study and divided into four different groups according to the day of sampling (1, 4, 7, and 11 days post-delivery). Glucose levels in blood and urine samples were evaluated and compared between groups. Correlation between glucose levels in blood and urine was also determined. RESULTS: Hypoglycaemia was diagnosed in 17.14% of the puppies and only on day 1 after delivery. A positive and significant correlation between blood and urine glucose concentration on day 1 after delivery was observed. No significant correlation between blood and urine glucose was observed on days 4, 7 and 11 after delivery. CONCLUSIONS: Urine concentration of glucose is a useful parameter to establish glycaemic status on the first day of life in canine puppies.

Can we contribute to the diagnosis of diabetes and regulation of blood glucose by increasing the urologists' awareness of glucosuria?

AIMS: Diabetes mellitus is a progressive, chronic, systemic, metabolic disease that must be managed effectively. Its prevalence is increasing rapidly. We investigated whether urologists' awareness and recognition of glucosuria contributed to the diagnosis of diabetes and regulation of blood glucose. METHODS: A total of 39,053 patients were retrospectively evaluated between January 2018 and February 2019. Of them, 16,211 had undergone urinalysis for varied reasons. Glucosuria was semi-quantitatively measured as (+), (++), (+++), and (++++). Patients were assessed in terms of whether they had been referred to endocrinology or internal medicine departments within the 15 days and the presence/absence of a previous or new diagnosis of diabetes mellitus by measuring blood glucose and HgbA1c levels. RESULTS: Glucosuria was detected in 665 patients (4.1%), of whom 495 were included in the study. 417 (84.2%) had been previously diagnosed with diabetes mellitus, and 56 (11.3%) newly received a diabetes mellitus diagnosis. Blood glucose and HbA1c values were normal in 22 (4.4%) patients with glucosuria. HgbA1c value was determined as 7 or above in 381 (91.3%) of 417 cases with a previous diabetes mellitus diagnosis. CONCLUSION: Referring all patients detected to have glucosuria in the spot urine test at any time regardless of fasting/non-fasting to the relevant departments can contribute to the diagnosis and treatment of diabetes mellitus disease.

Regional variance in the use of urine dipstick test for outpatients in Japan.

AIM: The urine dipstick is a simple diagnostic module for detecting proteinuria, haematuria and glycosuria and is favourably accepted in East Asia despite debates regarding its accuracy and target population, claiming that quantitative tests for a high-risk cohort should be more cost-effective. However, the current status of utilizing this test in these countries is not widely known due to lack of extensive data. We aimed to clarify the current nationwide and regional status of utilization of the urine dipstick test in an outpatient care setting and to determine the regional factors associated with adoption of this method. METHODS: This cross-sectional study used openly accessible data from the national claim database that included the health insurance claims data of the Japanese population in 2017. RESULTS: In total, 67 125 386 urine dipstick tests were performed compared with 1 862 700 quantitative urine protein tests and 17 544 949 urine sediment microscopy tests. Dipstick tests were employed principally for those who are >65 years old (60.3%) and, although the male population (52.5%) is generally larger, the female population is larger in age of 15 to 39 years and >85 years. Multivariate analysis with several regional parameters revealed that the test was performed more commonly in the areas that accommodate greater elderly population (P < .01). CONCLUSION: Despite a heated dispute, the urine dipstick test is performed even more frequently than the quantitative biochemical or microscopic sediment tests, especially in regions holding the larger elderly population, which suggests that the test forms a part of geriatric medical care.

A spherical covalent-organic framework for enhancing laser desorption/ionization mass spectrometry for small molecule detection.

A spherical vinyl-functionalized covalent-organic framework (COF-V) was prepared at room temperature by a facile method and applied as a novel substrate for surface-enhanced laser desorption/ionization mass spectrometry (SELDI-MS). Compared with conventional organic matrices, the spherical COF-V with high crystallinity and good monodispersity exhibited high sensitivity, no matrix background interference, wide-range applicability, high salt tolerance and reproducibility in the characterization of small molecules. Considering these advantages, the applicability of the spherical COF-V-based SELDI-MS method was successfully demonstrated by determining trace amounts of glucose in diabetic urine, which would be a promising candidate for clinical diagnosis of diabetes. In addition, the morphological effect and the desorption/ionization mechanism of the COF-V were investigated in detail and the results indicated that the spherical COF-V substrate could greatly enhance the LDI process compared with the bulk COF-V. This work not only extends the application of COFs in MS, but also offers a promising alternative for small molecule identification and clinical diagnosis of diabetes.

A feasible image-based colorimetric assay using a smartphone RGB camera for point-of-care monitoring of diabetes.

Urinary glucose determination using a glucose test strip is simple and convenient in daily self-monitoring of diabetes. However, diabetic patients exhibit acquired impaired color vision (ICV), which results in the inability to discriminate between hues. Even with the assistance of a color chart, it is still not easy for these patients to read the urinary glucose results with the naked eye. In this study, a smartphone camera using an image-based colorimetric detection method was successfully developed for quantitative analysis of urine glucose. A horseradish peroxidase-hydrogen peroxide-3,3'5,5'-tetramethylbenzidine (HRP-H2O2-TMB) system was optimized for a reliable and gradual color fading process via a glucose oxidase (GOD) catalyzed oxidation reaction. The color changes of the peroxidase-H2O2 enzymatic reactions in the 96-well microplate were captured by a smartphone RGB camera with subsequent detection of red, green, and blue (RGB) intensities decreasing at each image pixel. The highly quantitative relationships between the glucose concentrations and the color characteristic values of the blue channel of the captured images were successfully established. The high accuracy of this method was demonstrated in urine glucose measurements with a linear response over the 0.039 mg mL-1 to 10.000 mg mL-1 glucose concentration range and a 0.009 mg mL-1 detection limit. The method has great potential as a point-of-need platform for diabetic patients with defective color vision and features high accuracy and low cost.

A point-of-care diagnostics logic detector based on glucose oxidase immobilized lanthanide functionalized metal-organic frameworks.

In this work, a novel lanthanide functionalized metal organic framework enzyme (L-MOF-enzyme) composite has been first prepared via a surface attachment strategy between Eu3+@UMOF and glucose oxidase (GOx). Here, the Eu3+@UMOF can be used as a support for GOx immobilization and also a responsive fluorescent center towards glucose (Glu). The resulting material not only exhibits fascinating luminescence properties based on the 5D0→7F2 transition of Eu3+ and the catalytic performance of enzymes, but also some advantages of MOF-enzyme composites, including better stability, and great fluorescence selectivity and sensitivity towards Glu (detection limit = 0.2 µM). Besides, the composite exhibited an excellent selectivity and sensitivity towards Glu in serum and urine under room temperature and neutral conditions, which breaks the limitation of specific catalytic conditions of enzymes. Taking all the advantages of the L-MOF-enzyme composite, a point-of care (POC) diagnostics logic detector which can be used for the fluorescence detection of Glu in urine is designed. From the three outputs of the logic detector (L, M and H), we can intuitively realize the self-diagnosis of the three ranges of Glu concentrations that act as the inputs of the detector (0.1 µM-10 µM, 10 µM-10 mM, >10 mM) by the naked eye. The logic detector allows us, especially diabetics, to instantly detect glucose levels in the urine without going to the hospital for complicated inspections. This is the first attempt using L-MOFs combined with GOx to construct a POC diagnostics logic detector for fluorescence detection of Glu.

Enhanced peroxidase-like activity of AuNPs loaded graphitic carbon nitride nanosheets for colorimetric biosensing.

Nanozymes have emerged as promising alternatives to overcome the high cost and low stability issues of natural enzymes. Particularly, those with peroxidase-like activities have been extensively studied to construct versatile biosensors. In this article, we demonstrate that the modification of the graphitic carbon nitride nanosheets (g-C3N4 nanosheets) by plasmonic gold nanoparticles (AuNPs) greatly enhances its catalytic performance as peroxidase mimetic. In the presence of H2O2, the AuNPs@g-C3N4 nanosheets can catalyze the redox reaction of 3,3',5,5'- tetramethylbenzidine (TMB) to produce a blue color. Based on the observation, a colorimetric sensing method for glucose is further developed with the assistance of glucose oxidase (GOx). The linear range for glucose is from 5 to 100 µmol L-1 (R2 = 0.9967) and the limit of detection (LOD) is 1.2 µmol L-1. The LOD can be further lowered down to 0.75 µmol L-1 by using H2SO4 as termination agent and measuring the absorbance of the yellow product at λ = 451 nm. Moreover, the practical usefulness of AuNPs@g-C3N4 nanosheets as a peroxidase nanozyme for glucose determination in human serum and urine is also demonstrated.

[Semiquantitative glucose measurements in urine samples and urine soaked cat litter]. / Semiquantitative Glukosemessungen in Katzenharnproben und in mit Harn verklumpter Einstreu.

OBJECTIVE: Semiquantitative urine glucose measurements are a proposed alternative for the treatment surveillance of unmanageable diabetic cats. The primary objectives of this study were to determine the accuracy of 5 commercially available dipsticks, to re-evaluate a technique for detecting glucosuria in urine-soaked "clumping" type of cat litter described by Schaer and to validate a cat toilet with a sieve bottom. MATERIAL AND METHODS: A total of 93 urine samples were analysed using 5 different urine dipsticks. The correlation with a laboratory reference method and the diagnostic accuracy to diagnose pathological glucosuria > 1.48 mmol/l and urinary glucose concentrations ≥ 13.9 mmol/l (therapeutically important cut-off) were determined. Furthermore, the viability of 10 types of cat litter, a cat toilet with sieve bottom, 2 disinfectants, 2 cleaning agents and 2 cat litter deodorants were tested. RESULTS: The correlations of the dipstick results with the reference method were moderate (rSP = 0.633) to good (rSP = 0.846). The sensitivities and specificities to diagnose pathological glucosuria were 0.7-1 and 0.94-1, respectively. Urine glucose concentrations ≥ 13.9 mmol/l were detected with sensitivities of 0.65-1 and specificities of 0.97-1. Four cat litters, one dipstick and a disinfectant containing hydrogen peroxide caused false-positive colour reactions. Depending on the dipsticks and litter used, the measurements from soaked cat litter reduced the urine glucose concentrations by a median of 70-77 %. Pouring the probes into the cat toilet and subsequent measurements from the collecting tank did not falsify the results. CONCLUSION AND CLINICAL RELEVANCE: Not all urine dipsticks are suitable to monitor insulin therapy in diabetic cats. False positive colour reactions are possible when using dipsticks with high analytical sensitivities, some cat litters and oxidizing disinfectants. Measurements from the collecting tank of the cat toilet are superior to measurements using soaked clumping type of cat litter.

A Lower Baseline Urinary Glucose Excretion Predicts a Better Response to the Sodium Glucose Cotransporter 2 Inhibitor.

We aimed to identify the clinical variables associated with a better glucose-lowering response to the sodium glucose cotransporter 2 inhibitor ipragliflozin in people with type 2 diabetes mellitus (T2DM). We especially focused on urinary glucose excretion (UGE). This was a single-arm multicenter prospective study. A total of 92 people with T2DM aged 20 to 70 years with glycosylated hemoglobin (HbA1c) levels ≥7.0% and ≤9.5% were enrolled. Ipragliflozin (50 mg) was added to the background therapy for these people for 12 weeks. After 3 months treatment with ipragliflozin, the mean HbA1c levels were decreased from 7.6% to 6.9% and 62.0% of the people reached the HbA1c target of less than 7.0% (P<0.001). In addition, body weight, blood pressure, and lipid parameters were improved after ipragliflozin treatment (all P<0.001). The baseline HbA1c (r=0.66, P<0.001) and morning spot urine glucose to creatinine ratio (r=-0.30, P=0.001) were independently associated with the HbA1c reduction. Ipragliflozin treatment for 12 weeks improves glycemic control and other metabolic parameters. A higher HbA1c and lower UGE at baseline predicts a better glucose-lowering efficacy of ipragliflozin.

Evaluation of the effect of urine dip vs urine drip on multi-test strip results.

Standard operating procedures, including World Health Organization guidelines for packed cell volume, are established for in-clinic laboratory tests. No independent, evidence-based guidelines exist for dipstick urinalysis; however, manufacturer's instructions state to dip the stick into urine. In veterinary medicine, small volume urine samples could preclude dipping; therefore, a single drip per pad from a pipette or syringe is often performed. This study aimed to examine the differences between these two urine application methods prior to analysis, with the hypothesis that the method type would not effect on test results of dipstick analysis. To standardize the strip analysis method, a Siemens Clinitek Status + analyzer was used with Multistix10SG dipsticks. Three investigators tested urines from 53 dogs with a range of diseases by both methods. Results were assessed for the degree of agreement between the methods and within method variability. Overall, the agreement between methods was high. Within each method, the drip method variability was higher than that of the dip method (P = 0.012). Disagreements between methods were present, with pH and blood having the lowest agreement levels. Glucose was more likely to be positive on the drip compared with the dip methodology. This study demonstrates potential clinically relevant differences between the two methods and a higher level of variability with the drip methodology. Therefore, while the drip method could be used for practical reasons (eg, low sample volumes), this study supports the manufacturer's recommended method of dipping the dip stick into urine rather than dripping urine onto each pad with a pipette or syringe.

An Equipment-Free, Paper-Based Electrochemical Sensor for Visual Monitoring of Glucose Levels in Urine.

A novel electrochemical glucose sensor was created for a simple but semiquantitative visual screening of specific glucose concentrations in urine. This noninvasive glucose biosensor integrated a disposable, paper-based sensing strip and a simple amplifier circuit with a visual readout. The paper strip consisted of five enzyme-activated electrodes. Each electrode was connected to a specific indicator circuit that triggered a light-emitting diode (LED) when a predefined glucose concentration was reached. The device features (1) low-cost, disposable, paper-based glucose oxidase (GOx)/poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) sensing electrodes, (2) simple signal amplification, and (3) on-site, rapid, and visual detection. The sensor generated reliable, discrete visual responses to determine five glucose levels (1, 2, 3, 4, and higher than 4 mM) in urine in less than 2 min. This innovative approach will provide a simple but powerful glucose sensing paradigm for use in POC diagnostics.

Amelioration of diabetic nephropathy by SGLT2 inhibitors independent of its glucose-lowering effect: A possible role of SGLT2 in mesangial cells.

Several clinical studies have shown the beneficial effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on diabetic nephropathy. The underlying mechanisms are not fully understood. We found that administration of canagliflozin at a low dose (0.01 mg/kg/day) did not affect either blood glucose levels or glycosuria, but it improved albuminuria and mesangial expansion in db/db mice to a similar extent as at a high dose (3.0 mg/kg/day) that lowered blood glucose levels. This indicated the existence of a tubular SGLT2-independent reno-protective mechanism. Here we focused on the potential role of SGLT2 in mesangial cells (MCs). Western blot analysis revealed the expression of SGLT2 in cultured mouse MCs. Exposure of MCs to high glucose levels for 72 h significantly increased the expression of SGLT2. Canagliflozin or ipragliflozin (both 100 nM) treatment inhibited glucose consumption in the medium under high-glucose conditions but not under normal-glucose conditions. Furthermore, canagliflozin inhibited high-glucose-induced activation of the protein kinase C (PKC)-NAD(P)H oxidase pathway and increases in reactive oxygen species (ROS) production. Thus, the inhibition of mesangial SGLT2 may cause an inhibition of PKC activation and ROS overproduction in diabetic nephropathy, and this may at least in part account for the reno-protective effect of SGLT2 inhibitors.