Efficacy of intermittent empagliflozin supplementation on dietary self-management and glycaemic control in patients with poorly controlled type 2 diabetes: A 24-week randomized controlled trial.

Abstract

AIMS:

To explore the effects of intermittent use of empagliflozin, a sodium-glucose co-transporter-2 inhibitor, on dietary self-management and glycaemic control in patients with inadequately controlled type 2 diabetes.

MATERIALS AND METHODS:

We conducted a prospective, randomized, open-label, blinded-endpoint, parallel-group, comparative clinical trial of 50 patients with type 2 diabetes, treated with no more than three oral antidiabetic drugs (glycated haemoglobin [HbA1c] ≥52 mmol/mol but <86 mmol/mol). The participants were randomized to take 10 mg/d empagliflozin either every day (regular group, n = 25) or on the day on which they considered they had overeaten (intermittent group, n = 25) for 24 weeks. We limited empagliflozin prescription to half of the required period in the intermittent group. The primary endpoint was change in HbA1c at the end of the 24-week treatment period relative to baseline. The secondary outcomes included changes in body weight, daily energy intake and diabetes treatment-related quality of life (QoL). Energy intake was assessed using a diet-specific validated questionnaire rather than actual assessments of food intake.

RESULTS:

The intake rate of empagliflozin was 96.7 ± 7.2% for the regular group and 45.7 ± 7.0% for the intermittent group. Interestingly, ΔHbA1c was identical in the two groups (-0.64 ± 0.19% and - 0.65 ± 0.17%, respectively). Body weight decreased (-2.72 ± 0.52 and - 1.50 ± 0.45 kg, respectively) and diabetes treatment-related QoL increased significantly from baseline in both groups. Energy intake, however, decreased significantly only in the intermittent group (-221.0 ± 108.3 kcal/d).

CONCLUSIONS:

Intermittent empagliflozin supplementation is a useful therapeutic option that empowers dietary self-management, improves glycaemic control and is accompanied by body weight loss and an increase in diabetes treatment-related QoL in patients with inadequately controlled type 2 diabetes.

• Authors: Fukumi Yoshikawa, Naoki Kumashiro, Fumika Shigiyama, Hiroshi Uchino, Yasuyo Ando, Hiroshi Yoshino, Masahiko Miyagi, Kayoko Ikehara, Takahisa Hirose
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 21 Issue 2 Pg. 303-311 (02 2019) ISSN: 1463-1326 [Electronic] England
• PMID: 30187632 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2018 John Wiley & Sons Ltd.

Chemical References

• Benzhydryl Compounds
• Blood Glucose
• Glucosides
• Glycated Hemoglobin A
• empagliflozin

Topics

• Adult
• Aged
• Benzhydryl Compounds (administration & dosage)
• Blood Glucose (drug effects, metabolism)
• Diabetes Mellitus, Type 2 (blood, diet therapy, drug therapy)
• Diet
• Double-Blind Method
• Drug Administration Schedule
• Energy Intake (physiology)
• Female
• Glucosides (administration & dosage)
• Glycated Hemoglobin (drug effects, metabolism)
• Humans
• Japan
• Male
• Middle Aged
• Self-Management (methods)
• Treatment Outcome