{"title":"Evaluating Use of Empagliflozin for Diabetes Management in Veterans With Chronic Kidney Disease.","authors":"Chelsey Williams, Bobbie Bailey","doi":"10.12788/fp.0524","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>About 1 in 4 veterans have diabetes, and many also have chronic kidney disease (CKD). Empagliflozin, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, is approved for the treatment of diabetes. The purpose of this study was to evaluate the effectiveness of empagliflozin on hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) in patients with CKD.</p><p><strong>Methods: </strong>A retrospective chart review evaluated patients that had a type 2 diabetes diagnosis and stage 3 CKD prescribed empagliflozin for diabetes management between January 1, 2015, and October 1, 2022. Patient demographics, medication, HbA<sub>1c</sub> levels, and other data were collected from a random sample of 100 patients from 1771 potential study subjects.</p><p><strong>Results: </strong>There was no statistically significant difference in changes in HbA<sub>1c</sub> levels between those with stage 3 and stage 3b diabetes CKD who were taking empagliflozin (<i>P</i> = .51). Within each group, there were significant statistical differences in changes in HbA<sub>1c</sub> for patients with stage 3a (<i>P</i> < .05) and stage 3b (<i>P</i> = .02). Patients with stage 3a had a reduction in HbA<sub>1c</sub> of 0.65% and the stage 3b grow had a 0.48% reduction. There was a statistically significant weight change for patients in the stage 3a group (<i>P</i> < .05). Statistically significant differences were found in systolic (<i>P</i> = .003) and diastolic (<i>P</i> = .04) blood pressure for the stage 3a CKD group only. The most common adverse effects leading to discontinuation of empagliflozin were dizziness, increased incidence of urinary tract infections, and rash.</p><p><strong>Conclusions: </strong>Empagliflozin is a favorable option for reducing HbA<sub>1c</sub> levels in patients with diabetes and CKD.</p>","PeriodicalId":94009,"journal":{"name":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","volume":"41 Suppl 5","pages":"1-4"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745361/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Federal practitioner : for the health care professionals of the VA, DoD, and PHS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12788/fp.0524","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/17 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background: About 1 in 4 veterans have diabetes, and many also have chronic kidney disease (CKD). Empagliflozin, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, is approved for the treatment of diabetes. The purpose of this study was to evaluate the effectiveness of empagliflozin on hemoglobin A1c (HbA1c) in patients with CKD.
Methods: A retrospective chart review evaluated patients that had a type 2 diabetes diagnosis and stage 3 CKD prescribed empagliflozin for diabetes management between January 1, 2015, and October 1, 2022. Patient demographics, medication, HbA1c levels, and other data were collected from a random sample of 100 patients from 1771 potential study subjects.
Results: There was no statistically significant difference in changes in HbA1c levels between those with stage 3 and stage 3b diabetes CKD who were taking empagliflozin (P = .51). Within each group, there were significant statistical differences in changes in HbA1c for patients with stage 3a (P < .05) and stage 3b (P = .02). Patients with stage 3a had a reduction in HbA1c of 0.65% and the stage 3b grow had a 0.48% reduction. There was a statistically significant weight change for patients in the stage 3a group (P < .05). Statistically significant differences were found in systolic (P = .003) and diastolic (P = .04) blood pressure for the stage 3a CKD group only. The most common adverse effects leading to discontinuation of empagliflozin were dizziness, increased incidence of urinary tract infections, and rash.
Conclusions: Empagliflozin is a favorable option for reducing HbA1c levels in patients with diabetes and CKD.
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