Intervention: Canagliflozin
Trial phase: Phase 4
ATC code: A10BD16 | A10BK02
SMILES: [H][C@@]1(c2ccc(C)c(Cc3ccc(-c4ccc(F)cc4)s3)c2)O[C@H](CO)[C@@H](O)[C@H](O)[C@H]1O
Sex: All
Age groups: Adult | Older Adult
Healthy volunteers: No
Participants at risk: 34
Group description: 100 mg of Canagliflozin for 16 weeks

Canagliflozin: 100 mg
Eligibility criteria:
Inclusion Criteria:

Age 30-70 years
Currently treated with any combination of the following anti-diabetic therapies: metformin (1-2 grams), insulin, GLP-1 agonists, a DPP-IV inhibitor, or sulfonylureas
Hemoglobin A1C (HbA1C) between 7.0% and 10.0%
Body Mass Index (BMI) between 25 and 39.9 kg/m^2 (both inclusive)

Exclusion Criteria:

Type 1 diabetes
History of hyperosmolar nonketotic coma
History of diabetic ketoacidosis in the last 3 months
Abnormal CBC that is judged by physician to be unsafe to enroll or low hematocrit (<28 UNITS).
History of pancreatitis
History of diabetic ketoacidosis in the last 3 months
History of cancer (except basal cell carcinoma and cancer that is cured or not active or being treated in the past 5 years)
Heart attack or stroke within 6 months of screening
Clinically significant coronary and/or peripheral vascular disease that would be unsafe to enroll in the study.
Statin use started or dose change in the last 3 months
CKD Stages 3,4 and 5
Use of oral or injectable anti-diabetic medication other than any combination of the following anti-diabetic therapies: metformin (1-2 grams), insulin, GLP-1 agonists, a DPP-IV inhibitor, or sulfonylureas currently, or in the past 1 month.
Use of consistent long-term steroid medication (oral, inhaled, injected) within the last 3 months
Uncontrolled inflammatory disease, or current chronic use of anti-inflammatory drugs within the last 3 months. **This will be judged on a case by case basis by the PI**
Implanted devices (e.g., pacemakers) that may interact with Body Composition scale
Untreated Systolic Blood Pressure > 150 mmHg and diastolic Blood Pressure > 90 mmHg
Active wounds or recent surgery within 3 months
Untreated hyper/hypothyroidism

Physical and Laboratory Test Findings:

Pre-existing liver disease and/or ALT and AST >2.5X's UNL
Serum creatinine levels ≥2.0
Estimated CrCl < 60 mL/min (measured by eGFR value)
Triglycerides >450 mg/dL

Allergies and Adverse Drug Reactions:

Subjects with a history of any serious hypersensitivity reaction to Cana or another SGLT2 inhibitor.

Sex and Reproductive Status:

Women in reproductive age group will be included in the study but encouraged to use contraceptive method to avoid pregnancy within 16 weeks of study duration.
Women who are pregnant or breast-feeding will be excluded.

Other Exclusion Criteria:

Prisoners or subjects who are involuntarily incarcerated.
Subjects who are compulsorily detained for treatment of either a psychiatric or physical (e.g., infectious disease) illness.
Patients who are active smokers
Patients who are pregnant
Nursing women
Post-menopausal women who are on estrogen hormone replacement therapy will be excluded.
Patients on low dose oral contraceptives will be allowed to participate as these formulations contain very low amounts of estrogens.
Eligibility criteria for this study have been carefully considered to ensure the safety of the study subjects and to ensure that the results of the study can be used. It is imperative that subjects fully meet all eligibility criteria.