Physicians' Academy for Cardiovascular Education

test - SGLT2 inhibitor benefits younger, overweight, poorly controlled T2DM patients

SGLT2 inhibitor benefits younger, overweight, poorly controlled T2DM patients

Empagliflozin in combination with oral agents in young and overweight/obese Type 2 diabetes mellitus patients: A pooled analysis of three randomized trials

Literature - Romera I et al., J Diabetes Complications. 2016 - J Diabetes Complications. 2016; published online ahead of print

Background

The percentage of overweight individuals under 65 with type 2 diabetes mellitus (T2DM) and poor blood glucose control is rising. The combination of poor blood glucose control, BMI > 25 kg/m2 and younger age, exposes these individuals to increased hyperglycaemic states and a higher risk of long-term complications [1,2].

Sodium-glucose cotransporter 2 (SGLT2) inhibitors inhibit renal glucose reabsorption and minimise excess glucose in the urine, leading to significant HbA1c reductions particularly in overweight/obese patients [3]. Empagliflozin, a SGLT2 inhibitor, is also associated with body weight and systolic blood pressure reductions [4].

In this analysis from three phase 3 studies, the efficacy and safety of empagliflozin was evaluated in 439 T2DM patients younger than 65 years, with BMI 25–35 kg/m2 and poorly controlled HbA1c (≥64 mmol/mol), despite diet, exercise and a stable regimen (>12 weeks) of anti-diabetes treatment.

Main results

Adjusted mean change from baseline in body weight reduction at week 24 was −1.61 kg (95%CI: −2.16 to −1.05; P<0.001) for empagliflozin 10mg vs. placebo, and −1.81 kg (95% CI: −2.38 to −1.24; P<0.001) for empagliflozin 25mg vs. placebo.

Conclusion

In T2DM patients younger than 65 years, with BMI 25–35 kg/m2 and poorly controlled HbA1c levels (≥64 mmol/mol), the addition of empagliflozin to oral standard therapies was associated with a clinically and statistically significant reduction in HbA1c and in body weight compared to placebo, with a favourable safety profile. These data support an added benefit of the use of empagliflozin on top of standard therapy in this patient group.

References

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Find this article online at J Diabetes Complications