Effects of the Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor Empagliflozin Added to Metformin in Patients with Type 2 Diabetes

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is a chronic progressive disease characterized by a progressive decline in pancreatic beta-cell function and insulin resistance. Multiple blood glucose-lowering agents targeting the main pathogenic mechanisms of insulin deficiency and insulin resistance are available for the management of type 2 diabetes. However, many patients do not achieve or maintain recommended blood glucose targets even with combination therapies, which are often delayed. Therefore, this study aimed to observe the effects of Empagliflozin as an add-on to Metformin in patients with type 2 diabetes. Methods: This was a retrospective observational study and was conducted in the Department of Medicine, Popular Medical College Hospital, Dhaka, Bangladesh during the period from January 2023 to December 2023. In our study, we included 255 type 2 diabetes mellitus patients who came to receive treatment at the outdoor department of medicine of our hospital. The patients were divided into three groups- Group A (Patients who received the combination of Empagliflozin 10 mg and Metformin 1000 mg), Group B (Patients who received Empagliflozin 10 mg), and Group C (Patients who received Metformin 1000 mg). Result: We found the mean age was 55.8 ± 11.3 years. Most of our patients were male (60%). Among our patients, the majority (57.25%) of them had HbA1c of 8% to 9%. Most patients (60%) got < 8% HbA1c level in Empagliflozin 10 mg combined with metformin 1000 mg group at the end of our study. The majority (9.41%) of patients in the Empagliflozin 10 mg group had >9% HbA1c level compared to other groups. Dizziness, dyspepsia, diarrhea, nasopharyngitis, hyperglycemia, and hypoglycemia were the most common adverse events. Conclusion: The findings of the study showed that in people with Type 2 diabetes and insufficient glycaemic control, 52 weeks’ treatment with empagliflozin 10 mg as an add-on to metformin 1000 mg resulted in sustained and clinically substantial decreases in HbA1c, body weight,FPG, systolic and diastolic blood pressure.