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Empagliflozin-Metformin Combination Has Antioxidative and Anti-Inflammatory Properties that Correlate with Vascular Protection in Adults with Type 1 Diabetes

Janić M, Cankar M, Šmid J, France Štiglic A, Jerin A, Šabovič M, Janež A, Lunder M

Journal of diabetes research, 2022

40 participants · 21 citations

Abstract

Background and Aim. Our previous study showed that the empagliflozin-metformin combination significantly improved arterial function; i.e., it improved endothelial function (measured by flow-mediated dilation and reactive hyperaemia index) and reduced arterial stiffness (measured as pulse wave velocity and local carotid artery stiffness) in adults with type 1 diabetes. In the present study, we explored the underlying mechanism by investigating the antioxidative and anti-inflammatory properties of the empagliflozin-metformin combination (compared to the individual drugs or placebo) and its association with improving arterial function. Methods. 40 individuals with type 1 diabetes (average age of 44.7 ± 2.5 years) were randomized into four groups: (1) control (placebo), (2) empagliflozin 25 mg daily, (3) metformin 2000 mg daily, and (4) empagliflozin-metformin combination (25 mg and 2000 mg daily, respectively). At inclusion and after 12 weeks of treatment, the blood samples were collected, and the oxidative stress (total antioxidative status (TAS), superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid, advanced oxidation protein products (AOPP), advanced glycosylation end products ((AGE) and isoprostane), and inflammation (C-reactive protein (CRP) and interleukin-6 (IL-6)) parameters were determined. Results. The empagliflozin-metformin combination increased levels of the antioxidants (TAS, SOD, and GPx up to 1.1-fold; P < 0.01 ), decreased the levels of…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 40 participants or records.

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