Effects of the Selective Sodium-Glucose Cotransporter 2 Inhibitor Empagliflozin on Vascular Function and Central Hemodynamics in Patients With Type 2 Diabetes Mellitus
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From a clinical perspective, type 2 diabetes mellitus might also be regarded as a vascular disease, characterized by increased arterial stiffness. Empagliflozin is a selective sodium-glucose cotransporter 2 inhibitor shown to improve glycemic control after short- and long-term treatment.1 In the EMPA-REG OUTCOME study (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), a prospective randomized double-blind study in patients with type 2 diabetes mellitus with established cardiovascular disease, treatment with empagliflozin reduced the primary combined cardiovascular end point (3P-MACE [3-point major adverse cardiovascular event]), as well as secondary end points of hospitalization because of heart failure, cardiovascular morbidity, total mortality, and renal end points.2 We tested the hypothesis that improvements of vascular function and stiffness are involved in the observed improved cardiovascular and renal outcomes with empagliflozin treatment.
In this investigator-initiated prospective, double-blind, randomized, placebo-controlled, crossover, interventional single-center trial, 76 female and male patients (18–75 years of age) with diagnosed type 2 diabetes mellitus were randomized to either empagliflozin 25 mg orally once daily or placebo for 6 weeks, followed by the second 6-week treatment with the other compound (crossover). In 64 patients, any antidiabetic agent was withdrawn 4 weeks before the baseline examination. We analyzed the effects …