Empagliflozin as add-on therapy improves quality of life in diabetes patients

The study showed that empagliflozin, as an add-on, improved glycemic parameters, blood pressure, and quality of life (QoL) in T2D patients with hypertension. The study stated that QoL is a critical measure concerning a patient-centred treatment approach.

There is a continuous increase in the burden of diabetes and its complications; India is the world's second-most affected country by diabetes. It is estimated that more than 134 million will be affected by diabetes in India by 2045. Type 2 diabetes and hypertension coexistence adversely impacts the treatment outcomes, reduces the QoL, increases the risk of cardiovascular diseases, and may lead to mortality. Therefore, therapeutic regimens that have the potential to enhance clinical results and quality of life are needed.

Empagliflozin is an SGLT2 inhibitor that reduces renal glucose reabsorption in T2D patients. It controls the levels of blood sugar without requiring insulin. Further, studies have shown that it decreases blood pressure (BP) in T2DM patients with hypertension. Empagliflozin is helpful in diabetes that has not been appropriately managed with glimepiride, dipeptidyl peptidase-4 inhibitors, or metformin. However, currently, there is a lack of data on its impact on QoL in T2D patients with hypertension who are receiving triple drug therapy (metformin, glimepiride, and teneligliptin).

Against the above background, Imtiyaz Ahmed Najar, PhD Scholar, Department of Pharmacology, Lovely Professional University, Jalandhar, Punjab, India, and colleagues aimed to assess the quality of life in T2D patients with hypertension after add-on empagliflozin to triple-drug therapy.

For this purpose, the researchers performed prospective research on type 2 diabetes patients with hypertension who visited an endocrine outpatient clinic at a tertiary care referral institute. 25 mg once daily, Empagliflozin was administered to patients for three months as an add-on treatment.

An additional QoL study was conducted using an Urdu-translated QoL instrument for Indian T2D patients apart from the clinical assessment. A comparison was made between QoL outcomes before empagliflozin and those obtained after three months of treatment.

A total of 200 patients with T2DM and hypertension were recruited, with a mean age of 49.83 years.

The study led to the following findings:

• Empagliflozin as an add-on therapy remarkably improved various aspects of QoL, like role limitation due to physical endurance, physical health, general health, financial worries, symptom botherness, emotional/mental health, and diet satisfaction.
• The study found a significant reduction in mean change in systolic blood pressure (6.47 ± 4.40), diastolic blood pressure (1.56 ± 2.32), fasting blood glucose (42.38 ± 42.40), postprandial glucose (73.00 ± 44.70), and HbA1C (0.62 ± 0.34) during follow-up when compared to baseline.

To conclude, empagliflozin, as an add-on therapy, substantially improved various elements of QoL, such as physical endurance (PE), symptom botherness (SB), treatment satisfaction (TS), general health (GH), food satisfaction, and mental health. Also, it improved BP and glycemic parameters and QoL in T2D patients with hypertension.

Reference:

Najar IA, Masoodi SR, Mir SA, Bhat MH, Patyar RR, Patyar S. Impact of empagliflozin add-on therapy on quality of life in patients of type 2 diabetes mellitus with hypertension: A prospective study. Indian J Public Health 2022;66, Suppl S1:41-4