Evaluating Use of Empagliflozin for Diabetes Management in Veterans With Chronic Kidney Disease.

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 A_1c (HbA_1c) 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, HbA_1c 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 HbA_1c 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 HbA_1c for patients with stage 3a (P < .05) and stage 3b (P = .02). Patients with stage 3a had a reduction in HbA_1c 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 HbA_1c levels in patients with diabetes and CKD.