Effects of empagliflozin on insulin initiation or intensification in patients with type 2 diabetes and cardiovascular disease: Findings from the EMPA-REG OUTCOME trial
Diabetes, Obesity and Metabolism — Vaduganathan M, Inzucchi SE, Sattar N, et al. | October 12, 2021
In patients with type 2 diabetes and cardiovascular disease, researchers examined how empagliflozin vs placebo influences subsequent insulin initiation or dosing changes.
A total of 7,020 patients received empagliflozin 10 mg, 25 mg, or placebo in EMPA-REG OUTCOME.
There were 3,633 (52%) participants who were not receiving insulin treatment at baseline; in these patients, empagliflozin led to a reduction in new use of insulin vs placebo by 60%.
A total of 3,387 (48%) patients were using insulin at baseline; empagliflozin use in these patients lowered the necessity for a greater than 20% insulin dose increase by 58% and increased the proportion achieving sustained greater than 20% insulin dose reductions without subsequent increases in HbA1c compared with placebo (9.2% vs. 4.9%).
Overall, insulin initiation and substantial increases in insulin dose are markedly and durably delayed when empagliflozin is provided, with attainment of sustained reductions in insulin requirements over time.