Highlights
- •Empagliflozin has sustainable improvement in glucose control, weight and blood pressure.
- •Empagliflozin improves cardiovascular risk factors and retards renal disease progression.
- •Genital mycotic infections and features of hypovolaemia were the common adverse events.
- •Non-severe hypoglycemia in the first few months was common among patients already on insulin or sulfonylureas.
Abstract
Aims
SGLT2 inhibitors provide cardiovascular and renal protection in people with type 2
diabetes (T2DM). Real-world data on their effect on improving glucose and cardiovascular
risk factors, and adverse effects in South Asians are limited.
Methods
We retrospectively analyzed clinical, demographic, anthropometric and biochemical
data among adults with T2DM, commenced on empagliflozin and followed up for at least
one month in a diabetes clinic in Colombo.
Results
Among 1523 participants (men 49.6 %, age 54.9 (± 10.8) years, diabetes duration 11.5
(± 7.6) years, body mass index 28.2 (± 4.5 kg/m2), over a median follow up of 12 months (range: 1–24 months), reduction in HbA1c,
weight, systolic blood pressure (SBP) and urine albumin-creatinine ratio were evident
within the first month. Benefits sustained up to two-years (mean changes from baseline:
HbA1c − 0.31 (± 1.49), weight − 1.14 (± 4.17), SBP − 3.44 (± 21.75), UACR − 19.84
(± 108.22) follow up. eGFR declined by the third month, returned to baseline by 12th
and remained stable over 24 months. Higher baseline HbA1c, weight and SBP predicted
greater decline in HbA1c, weight and SBP respectively. Weight reduction independently
predicted the SBP reduction. Eighteen participants per 100 patient-years discontinued
therapy due to adverse effects: genital mycotic infections and features of hypovolaemia
were the commonest. We observed only two events of diabetic ketoacidosis.
Conclusions
Empagliflozin effectively improves glucose, weight and SBP and retards progression
of renal impairment in South Asians with T2D. Genital mycotic infections and hypovolaemia
were the commonest reasons for discontinuation. Careful patient selection and advice
can avoid other sinister complications.
Keywords
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Article info
Publication history
Published online: November 29, 2022
Accepted:
November 19,
2022
Received in revised form:
October 19,
2022
Received:
June 7,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
