Diabetes is an urgent worldwide health issue, especially in Pakistan. The International Diabetes Federation (IDF) Atlas reported by Sun et al. (2022), ranks diabetes mellitus as the third most common illness worldwide, affecting 33 million Pakistanis. This rising tendency is especially noticeable in lower-middle-income nations, emphasizing the necessity for competent management. Insulin resistance complicates diabetes care (Freeman and Pennings 2018). Many reasons cause insulin resistance, including obesity and diabetes dyslipidemia (Fujji et al., 2018). This problem requires diverse methods to glycemic control, weight management and lipid profile modification.
Evaluating the efficacy and safety of empagliflozin addition to insulin and oral antidiabetic medication (OAD) regimen in poorly controlled type 2 diabetes and obese patients
Findings
nsulin resistance complicates diabetes care. Its effectiveness and tolerability as an addition to metformin, DPP4 inhibitor and insulin treatment in type 2 diabetic patients will be examined in this research. Participants with type 2 diabetes from poor socio-economic backgrounds had HbA1c values ≥8.5% when using Insulin+Metformin+DPP-4 inhibitors. They received 10mg Empagliflozin daily for 12 weeks (n=143). The main outcome was change in HbA1c at 12th week from baseline. Secondary outcomes were baseline weight and week 12 FPG. Adjusted mean (SE) HbA1c increases at week 12 were: Mean±SD 10.38 (6.8-17.0) vs. Mean±SD 9.05±1.77 (5.60-16.0) with empagliflozin 10mg. When added to the regimen, empagliflozin significantly reduced FPG, systolic and diastolic blood pressure. The mean (SE) BMI increases from baseline were 31.28±5.89 (16.0-66.0) and 29.73±5.47 (3.0-46.0) with 10mg empagliflozin. Two individuals experienced urinary tract infections as AEs, but no genital infections. Adding empagliflozin 10mg daily to metformin+DPP4 inhibitor+insulin improved glycemic control, body weight and blood pressure for 12 weeks. The intervention was well-tolerated, highlighting empagliflozin’s therapeutic potential.