Endocrine Abstracts

Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors demonstrated beneficial effects on cardiovascular and renal events in patients with type 2 diabetes mellitus. The mechanisms underlying these effects are not fully elucidated. Aim of this study was to investigate whether empagliflozin is able to affect arterial stiffness/pulse wave velocity in type 2 diabetic patients.

Methods: Pulse wave velocity and other parameters of arterial stiffness were assessed before and after a 3-month treatment with empagliflozin in 16 consecutive T2DM outpatients; data were compared with 16 T2DM outpatients not treated with SGLT2 inhibitors.

Results: The sex of the patients and the duration of diabetes mellitus did not differ between groups. However age was significantly higher in the empagliflozin group at baseline compared to controls (64.1±8.68 vs 74.45±8.13, P < 0.05). Empagliflozin treatment significantly decreased HbA1c after 12 weeks of treatment (7.9±0.78 vs 7.04±1.09%, P < 0.008.). After 12 weeks’ treatment, empagliflozin significantly improved PWV compared to controls not treated with SGLT2-i (ΔPWVV -0.68±1.1 vs 0.89±1,6 p <0.004, P = 0.0065 with age and HbA1c as covariates). Moreover body weight significantly decreased in the empagliflozin group (86.75±16.16 vs 81.71±16.5 kg, p =0.001) compared to controls (in whom remained unchanged) as long as BMI (30.48±5.4 versus 28.75±5.66 kg/m², P < 0.002) compared to controls (in whom remained unchanged). Estimated glomerular filtration rate (eGFR) remained unchanged in the two groups during the study whereas urine Albumin to Creatinine ratio significantly improved with empagliflozin (17.8±46.8 vs 12.2±35.7 mg/mmol, P = 0.049).

Discussion: In this ‘real clinical practice’ study the potential effect of empagliflozin treatment on arterial function in T2DM patients was extensively investigated. Arterial stiffness was significantly decreased in the group treated with the empagliflozin and the difference was significant compared to the control group. Significantly improvement in urine Albumin to Creatinine ratio suggest an improvement of endothelial function in these patients that could be involved in reducing arterial stiffness.