Mohammed Umar Farooque1, Bharat Bhushan2
To study the analysis of metabolic parameters in patients with type 2 diabetes mellitus on empagliflozin, which is a SGLT2 inhibitor.
MATERIALS AND METHODS
This study was a prospective study of 120 patients with uncontrolled type 2 diabetes mellitus who were admitted as outpatients in JLNMCH Hospital, Bhagalpur. This study was conducted from February 2017 to April 2017. Informed consent was taken from each patient who participated in the study and the study protocol was approved by the institutions ethics and review board.
Inclusion Criteria- Patients with type 2 diabetes mellitus and HbA1c >8% meeting any one of the criteria- Patients who were on dual therapy (metformin + sulfonylurea/DPP4 inhibitor); patients who were on triple therapy (metformin + sulfonylurea + DPP4 inhibitor); patients who were on insulin and triple oral therapy (metformin + sulfonylurea + DPP4 inhibitor).
Exclusion Criteria- Patients who had history of genital mycotic infections, recurrent urinary tract infections, pyelonephritis, acute illness, type 1 diabetes, pregnant or lactating women, those patients who were with an eGFR below 45.
The mean age, duration of diabetes, weight and HbA1c in the study population was 54.36 ± 0.88 years, 14.2 ± 3.6 years, 76.25 ± 2.11 kgs and 9.66 ± 0.22%, respectively. The changes in weight and HbA1c were statistically significant across all groups. In 5% of the patients, genital pruritus was reported. Mycotic genital infection was seen in none of the patients on examination. All the four groups chose to discontinue the use of empagliflozin as a result of pruritus at follow up. The baseline daily insulin dose was 42 ± 25 units, and at 4 months, it was reduced to 34 ± 20 units. At follow up, the reduction in insulin level was 19.1% when compared to baseline.
This study showed that there was an improvement in glycaemic control and body weight with minimal side effects when SGLT2 inhibitor was added at any stage of disease with any of the pre-existing therapeutic agents for patients who had uncontrolled T2DM.