Empagliflozin (Jardiance) – complementary drug therapy to insulin injections?

This trial investigated the effect of empagliflozin (Jardiance) on daily glucose levels in people with type 1 diabetes mellitus (T1DM).

Empagliflozin is a drug approved for the treatment of type 2 diabetes. It causes sugar in the blood to be released from the body via the urine. However, recent studies have shown that empagliflozin is also beneficial for patients with T1DM. It can improve glucose control and reduce the amount of insulin that needs to be taken. However, whether or not empagliflozin is more effective during the day (when patients are eating) or overnight (when patients are fasting – not eating or drinking) is still unclear.  

The current study more closely examined the effects of empagliflozin in patients with T1DM. In this trial, 40 people with T1DM (26 on insulin pumps and 14 on insulin injections) were treated with a once daily dose of empagliflozin for 8 weeks. The participants used specialized glucose monitors, which allowed glucose levels to be measured 24 hours a day. As empagliflozin causes sugar in the blood to be released from the body via the urine, insulin doses were decreased by 30% to prevent very low blood glucose levels. Patients were followed for 2 weeks following the end of treatment.

HbA1c levels (average blood glucose levels over the past 3 months) were improved after 8 weeks of treatment. Improvements in nighttime glucose levels were more noticeable than the improvements in daytime glucose levels. Glucose variability (the range of blood glucose levels seen in a day) decreased with empagliflozin treatment, and increased once treatment was finished, though this result was not statistically significant.

The study concluded that empagliflozin was more effective at improving nighttime glucose levels than daytime glucose levels.

This study was funded by Boehringer Ingelheim and Eli Lilly, the developers of the drug.