Semaglutide Versus Empagliflozin in Uncontrolled Type 2 Diabetes: A Cohort Study With 18 Months of Follow-Up (SEMPA18)
Abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a chronic disease that substantially increases morbidity and mortality through its cardiovascular and renal complications. Beyond mere glycemic control, current guidelines from the European Society of Cardiology (ESC) and Kidney Disease: Improving Global Outcomes (KDIGO) recommend interventions that confer additional cardiovascular and renal benefits. Objective: This study aims to assess and compare the efficacy of semaglutide versus empagliflozin in improving glycemic control, weight, blood pressure, and renal function in patients with uncontrolled T2DM after 18 months of follow-up. Methods: This retrospective cohort study included 41 patients with uncontrolled T2DM (glycated hemoglobin (HbA1c) > 7%) who received either empagliflozin (n=20) or semaglutide (n=21) as monotherapy. Clinical and laboratory parameters (HbA1c, fasting plasma glucose, body weight, systolic and diastolic blood pressure, serum creatinine, estimated glomerular filtration rate (eGFR), and urine microalbumin) were measured at baseline and 18 months (SEMPA18). Changes were compared between the two groups using appropriate statistical methods. Results: Of the 41 participants (58.5% male), 20 were treated with empagliflozin and 21 with semaglutide. After 18 months, median HbA1c decreased from 7.60% to 6.85% in the empagliflozin group (100% improved) and from 7.90% to 7.00% in the semaglutide group (95.2% improved). A reduction in body weight of 5% or more…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 41 participants or records.
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