Combination therapy in type 2 diabetes mellitus

Adding empagliflozin to basal insulin

Andrew Ahmann

Research output: Contribution to journalComment/debate

3 Citations (Scopus)

Abstract

Type 2 diabetes mellitus (T2DM) management is complex, with few patients successfully achieving recommended glycemic targets with monotherapy, most progressing to combination therapy, and many eventually requiring insulin. Sodium glucose cotransporter 2 (SGLT2) inhibitors are an emerging class of antidiabetes agents with an insulin-independent mechanism of action, making them suitable for use in combination with any other class of antidiabetes agents, including insulin. This review evaluates a 78-week, randomized, double-blind, placebocontrolled trial investigating the impact of empagliflozin, an SGLT2 inhibitor, as add-on to basal insulin in patients with inadequate glycemic control on basal insulin, with or without metformin and/or a sulfonylurea. Empagliflozin added on to basal insulin resulted in significant and sustained reductions in glycated hemoglobin (HbA1c) levels compared with placebo. Empagliflozin has previously been shown to induce weight loss, and was associated with sustained weight loss in this study. This combination therapy was well tolerated, with similar levels of hypoglycemic adverse events in the empagliflozin and placebo groups over the 78-week treatment period. Urinary tract infections and genital infections, side effects associated with SGLT2 inhibitors, were reported more commonly in the empagliflozin group; however, such events led to treatment discontinuation in very few patients. These findings suggest that, with their complementary mechanisms of action, empagliflozin added on to basal insulin may be a useful treatment option in patients on basal insulin who need additional glycemic control without weight gain.

Original languageEnglish (US)
Article number212288
JournalDrugs in Context
Volume4
DOIs
StatePublished - Nov 11 2015

Fingerprint

Type 2 Diabetes Mellitus
Insulin
Sodium-Glucose Transport Proteins
Therapeutics
Weight Loss
Placebos
empagliflozin
Metformin
Glycosylated Hemoglobin A
Hypoglycemic Agents
Urinary Tract Infections
Weight Gain
Infection

Keywords

  • Blood glucose
  • Body weight
  • Combination therapy
  • Empagliflozin
  • Hypoglycemic agents
  • Insulin
  • Sodium glucose cotransporter 2
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Pharmacology
  • Molecular Medicine

Cite this

Combination therapy in type 2 diabetes mellitus : Adding empagliflozin to basal insulin. / Ahmann, Andrew.

In: Drugs in Context, Vol. 4, 212288, 11.11.2015.

Research output: Contribution to journalComment/debate

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