UPDATE ON THE RELATIONSHIP BETWEEN EMPAGLIFLOZIN AND INSULIN IN T2DM.

Dear my friends and fellow Colleagues, Here is an update on Relationship between Empagliflozin and Insulin usage in T2DM. T2DM patients treated with Empagliflozin in EMPA-REG study had a significantly reduced need for Insulin initiation in Insulin naive patients. There was a decrease in Insulin intensification in patients already on Insulin therapy. A Post hoc analysis from EMPA-REG Trial. ADA Virtual Meeting, June, 2020. Regards and thanks, Dr Sepuri Krishna Mohan.

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Excellent wonder drug cardioprotective also add metformin good drug
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Sir it is wonderful update I want to ask a question every 2or 3 pt is suffering from T2DM what combination is most effective under present circumstances because bSL and mental anxiety of majority of pt remains same despite of medicine and diet even little bit exercise.
Dear Ashok Leel Sir, Very valuable question indeed. In case of affordability combination of Metformin plus Empagliflozin and Linagliptin in addition to either Gliclazide or Glimepiride. In case of Non affordability, Metformin plus Gliclazide/Glimepiride plus 7.5 mg of Puoglitazone (If it's not contraindicated) plus Voglibose 0.3 mg. Still not to the control add Vildagliptin 50 mg BD which costs Rs 5/- now as it's off patent. Think of either Basal Insulin or Biphasic Premixed to the above combination therapy sir. @Dr Ashok Leel sir Regards and thanks, Dr Sepuri Krishna Mohan. Any clarification sir, please call me at my personal mobile 9440208461.
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Sir nice update but i feel very reluctant in using SGLT2 'S but this has given a new spirit...but still want to ask u that is it much safe to give sglt2 if reqd in pat with hba1c >9
Dear Rahul, As per the ADA guidelines we are suppose to initiate Insulin Therapy if HbA1c is > 9%, but if you feel that the patient of T2DM is either at risk of ASCVD or Established ASCVD, you always can start an SGLT2 Inhibitor even the HbA1c is around 7% to 7.5%. As per the 2020 ADA/EASD guidelines, Either GLP1 RA or SGLT2 Inhibitor is the first drug of Choice with or without Metformin in Naive T2DM with Established ASCVD or at risk of developing ASCVD. So in case the HbA1c is more than 9% in the absence of ASCVD, you start Insulin and as an add on you can go for the Combination of DPP4 Inhibitor plus SGLT2 Inhibitor or SGLT2 Inhibitor alone. Regards and thanks, Dr Sepuri Krishna Mohan. @Dr Rahul Mohtra.
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New uptodate data for wonderful drugs to reduce and avold insulin for which pt becomes more phobic.study very helpful and fruitful for Type 2DM victim.
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