Metabolic effects of empagliflozine

Abstract

Potentially beneficial metabolic effects of empagliflozin remain "overshadowed" by the undeniable benefits of this drug in terms of cardio- and renoprotection. Today, there is a large data array (meta-analyses, systematic reviews and separate cohort studies with empagliflozin) that confirm the beneficial effect of this drug on various metabolic processes, which was systematized in this scientific review. It is emphasized that the antihyperglycemic effect of the drug does not depend on the secretion of insulin by β-cells of the pancreas and insulin resistance, it is manifested only in conditions of glucosuria and limited by eGFR. Empagliflozin combines well with all oral and parenteral hypoglycemic drugs; combination with drugs that have a potential risk of hypoglycemia (insulin and sulfonylurea drugs) requires a dose reduction of the latter. The durability of empagliflozin allows to maintain the achieved levels of glycated hemoglobin for a long time and postpone the start of insulin therapy. Weight loss by drug using corrects blood pressure and insulin resistance. In addition to the ability to reduce the level of uric acid and postpone the appointment of antigout drugs, empagliflozin can be considered a drug that has a multi-vector effect on various component of the metabolic syndrome. Promising areas of the drug using are reducing the risk of nephrolithiasis, steatosis and slowing down the progression of liver fibrosis.