How effective is self-management with empagliflozin in the treatment of type 2 diabetes?

This study aimed to see how effective intermittent use of empagliflozin (Jardiance) controlled by the patients is in the treatment of poorly controlled type 2 diabetes (T2D). The main finding of the study was that intermittent use of empagliflozin controlled blood sugars as effectively as those who take it every day.

Empagliflozin is a blood sugar lowering drug used in the treatment of T2D. It is an SGLT2 inhibitor. It works by blocking the uptake of sugar in the kidney back into the blood. Instead, the sugar gets removed from the body in the urine.

A large amount of sugar in the urine can result in side effects such as urinary tract infections and volume depletion (removing too much water from the body). Intermittent use of empagliflozin can reduce the likelihood of these side effects. However, it is unknown how effective the intermittent use of empagliflozin is on controlling weight and blood sugar levels in patients with T2D.

This study included 50 patients with T2D. Patients were randomly selected to either take 10mg empagliflozin every day (regular group) or to take 10mg empagliflozin intermittently when they felt that they had overeaten (intermittent group). Patients were treated for 24 weeks.

At the end of the study, patients in the intermittent group took half of the quantity of empagliflozin of the regular group. After 24 weeks of treatment, HbA1c (test of blood sugar control) significantly improved in both groups. The reduction in HbA1c was similar in both regular (-0.64%) and the intermittent groups (-0.65%). Body weight decreased significantly in both regular group (-2.72kg) and the intermittent group (-1.5kg), but more significantly in the regular group. Quality of life also improved significantly in both groups.

Side effects to the treatment were mostly mild and no patient stopped treatment due to side effects. The most common side effect was frequent daytime urination.

The authors concluded that treatment with intermittent empagliflozin is as useful in T2D as continuous administration. 

This study received funding from Boehringer Ingelheim and Eli Lilly and Company, the developer of empagliflozin. The number of patients included in this study was small and also all the participants were Japanese. Larger studies in more diverse populations are needed.