SAT-LB031 Empagliflozin as an Add-On Medication to Subjects Uncontrolled on DPP4 Inhibitors and Metformin: Real World Data Supporting the Use of Empagliflozin as a Rational Second Add-On in Indian Type 2 Diabetic Patients

A huge burden of uncontrolled type 2 diabetes mellitus (T2D) prevails in the Indian settings with an estimated prevalence of patients with >7 % HbA1c at 63 %(1) and glycaemic control tends to decline over time with monotherapy(2). Newer guidelines supported the use of DPP4 inhibitors along with SGLT2 inhibitors as sequential therapy in patients with type 2 diabetes mellitus. This study evaluated the real-world clinical effectiveness of Empagliflozin as second add-on therapy in overweight subjects with inadequately controlled type 2 diabetes mellitus (T2DM). This single-centre study included overweight adult subjects with poorly controlled T2DM on optimal dose of metformin and DPP4 inhibitors, (N, 110) (mean glycated haemoglobin [HbA1c] (standard deviation [SD]), 7.65 [± 0.34] %; and BMI [SD], 28.39 [± 1.87] kg/m2) treated with Empagliflozin (25 mg) as add-on therapy. Follow-up improvements in outcomes were analysed using the paired t-test. Safety parameters were also evaluated. The mean age and weight at baseline were 42 ± 9.6 years and 81.23 ± 5.54 kgs respectively, with a male to female ratio of 1:1. An established cardiovascular disease was present in 18.2 % patients. At the 24-week follow-up, Empagliflozin as add-on therapy demonstrated a significant reduction (P< 0.0001) in HbA1c, body weight and BMI, with a mean reduction (MR [SD]) of 0.46 [0.44-0.48] %, 5.22 [4.92-5.51] kg, and 1.82 [1.72-1.92] kg/m2, respectively, in the overall population. Reduction in urine albumin/creatinine ratio [U-ACR] 14.7 [10.61-18.79] mg/g), SBP of 2.89 mmHg [2.24-3.54], and serum glutamic-pyruvic transaminase (10.95 [9.86-12.03] U/L) were also significant (P<.0.0001). The reduction in serum glutamic-oxaloacetic transaminase (0.76 [0.33-1.2] U/L) too was significant (P=0.0001). The target HbA1c of <7% (53 mmol/mol) was achieved in more subjects (31.8%) with the addition of Empagliflozin. Genital mycotic infection was reported in 9 patients. Empagliflozin as an add-on therapy was well tolerated with significant improvement in HbA1c, body weight, BMI, U-ACR, systolic blood pressure and serum transaminases levels in overweight Indian patients with T2DM. Not received any institutional grant. Saydah SH, Fradkin J, Cowie CC. Poor Control of Risk Factors for Vascular Disease Among Adults With Previously Diagnosed Diabetes. JAMA. 2004;291(3):335-342. doi:10.1001/jama.291.3.335 Turner RC, Cull CA, Frighi V, Holman RR, for the UK Prospective Diabetes Study (UKPDS) Group. Glycemic Control With Diet, Sulfonylurea, Metformin, or Insulin in Patients With Type 2 Diabetes Mellitus: Progressive Requirement for Multiple Therapies (UKPDS 49). JAMA. 1999;281(21):2005-2012. doi:10.1001/jama.281.21.2005 Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.