Canagliflozin is a prescription diabetes drug that makes the kidneys flush excess sugar into the urine, with effects reaching beyond blood sugar. In people with heart, kidney, or metabolic disease it dependably protects the heart and kidneys. Its longevity appeal rests on a male-mouse lifespan study and resemblance to eating less; human benefit remains unproven. (Full Review)
| Marker | Target | Why |
|---|---|---|
| eGFR | > 90 mL/min/1.73m² | Tracks kidney function; determines eligibility and safety |
| Serum creatinine | 0.7–1.0 mg/dL | Underlies the eGFR estimate; flags acute changes |
| Potassium | 4.0–4.5 mmol/L | Detects the drug's mild potassium-raising effect |
| Hemoglobin A1c | < 5.4% | Gauges average blood sugar and metabolic effect |
| Fasting glucose | 75–90 mg/dL | Immediate blood-sugar effect |
| Blood pressure | ~110–120 / 70–80 mmHg | Captures the blood-pressure-lowering effect and dehydration risk |
| LDL cholesterol | < 100 mg/dL | Monitors the small LDL rise seen with the class |
| Uric acid | 3.5–5.5 mg/dL | Tracks the beneficial urate-lowering effect |
| Beta-hydroxybutyrate | < 0.6 mmol/L | Screens for ketoacidosis risk, especially if fasting or low-carb |
Cadence: Baseline before starting; ~2–4 weeks after starting, then every 3–6 months, and during any acute illness