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Takumi, T., Tamada, K., Hatanaka, F., Nakai, N
The precise mechanism of action by which SGLT2 inhibitors act at this level remains to be defined, but it does not seem to depend entirely on weight loss.30,37 Unlike the myocardium, SGLT2 receptor expression has been found in adipose tissue samples from patients undergoing cardiac surgery.38 In these same clinical samples, dapagliflozin was found to induce higher glucose uptake, lower expression of inflammatory cytokines, and better differentiation of epicardial adipocytes
Completely thawed cold packs suggest the shipment spent significant time above optimal temperature
Note that creatine causes 2 to 4 pounds of intracellular water retention in muscle tissue, which will show on the scale but does not represent fat gain