- Clinical Study
- Glycemic Efficacy and Metabolic Consequences of an Empagliflozin Add-on versus Conventional Dose-Increasing Strategy in Patients with Type 2 Diabetes Inadequately Controlled by Metformin and Sulfonylurea
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Yujin Shin, Ji Hye Moon, Ho Jun Chin, Ele Ferrannini, Soo Lim
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Endocrinol Metab. 2020;35(2):329-338. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.329
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Abstract
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- Background
We assessed the glucose-lowering efficacy of adding empagliflozin versus dose escalating existing medications in patients with uncontrolled type 2 diabetes (T2D).
Methods This was a 6-month retrospective case-control study in subjects with uncontrolled T2D (glycated hemoglobin [HbA1c] >7%) on conventional treatment. The study group started add-on therapy with empagliflozin (10 mg once a day) while the control group was up-titrated with existing medication, using either monotherapy or a combination of metformin, sulfonylurea, and a dipeptidyl peptidase-4 inhibitor. The primary endpoints included changes in HbA1c, fasting plasma glucose (FPG), and 2-hour postprandial glucose (PP2) levels. Secondary outcomes included changes in body composition, body mass index (BMI), and serum ketone bodies, and urinary excretion of sodium, potassium, chlorine, calcium, phosphorus, and glucose.
Results After treatment, the reduction in HbA1c was significantly greater in the empagliflozin group than in controls (from 8.6%±1.6% to 7.6%±1.5% vs. 8.5%±1.1% to 8.1%±1.1%; P<0.01). Similar patterns were found in FPG and PP2 levels. Empagliflozin decreased systolic and diastolic blood pressure, triglycerides, and alanine and aspartate aminotransferase levels. Body weight, BMI, waist circumference, fat mass, and abdominal visceral fat area decreased significantly while lean body mass was maintained. Total ketones, β-hydroxybutyrate, and acetoacetate levels increased significantly after empagliflozin.
Conclusion In addition to glucose lowering, an empagliflozin add-on regimen decreased blood pressure and body fat, and improved metabolic profiles significantly. Empagliflozin add-on is superior to dose escalation in patients with T2D who have inadequate glycemic control on standard medications.
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Citations
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Hun Jee Choe, Won Chang, Matthias Blüher, Steven B. Heymsfield, Soo Lim Cardiovascular Diabetology.2024;[Epub] CrossRef - Sodium glucose co-transporter-2 inhibitor, Empagliflozin, is associated with significant reduction in weight, body mass index, fasting glucose, and A1c levels in Type 2 diabetic patients with established coronary heart disease: the SUPER GATE study
Satilmis Bilgin, Ozge Kurtkulagi, Tuba Taslamacioglu Duman, Burcin Meryem Atak Tel, Gizem Kahveci, Murat Kiran, Eray Erge, Gulali Aktas Irish Journal of Medical Science (1971 -).2022; 191(4): 1647. CrossRef - A randomized clinical trial evaluating the effect of empagliflozin on triglycerides in obese adults: Role of visceral fat
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Soo Lim, Minji Sohn, Yujin Shin, Ele Ferrannini Diabetes, Obesity and Metabolism.2022; 24(4): 757. CrossRef - Correlation of dynamic membrane fluctuations in red blood cells with diabetes mellitus and cardiovascular risks
Minji Sohn, Ji Eun Lee, MinGeun Ahn, YongKeun Park, Soo Lim Scientific Reports.2021;[Epub] CrossRef - Comparison betweeen dapagliflozin add-on therapy and insulin dose escalation in patients with uncontrolled type 2 diabetes treated with insulin: DVI study
Yujin Shin, Haeri Choi, Soo Lim Diabetes Research and Clinical Practice.2021; 175: 108843. CrossRef - Impact of COVID-19 and Associated Preventive Measures on Cardiometabolic Risk Factors in South Korea
Minji Sohn, Bo Kyung Koo, Ho Il Yoon, Kyoung-Ho Song, Eu Suk Kim, Hong Bin Kim, Soo Lim Journal of Obesity & Metabolic Syndrome.2021; 30(3): 248. CrossRef
- Clinical Study
- Effect of Lactobacillus sakei, a Probiotic Derived from Kimchi, on Body Fat in Koreans with Obesity: A Randomized Controlled Study
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Soo Lim, Ji Hye Moon, Chol Min Shin, Dahye Jeong, Bongjoon Kim
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Endocrinol Metab. 2020;35(2):425-434. Published online June 24, 2020
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DOI: https://doi.org/10.3803/EnM.2020.35.2.425
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- Background
The increased prevalence of obesity has led to increases in the prevalence of chronic diseases worldwide. There is interest whether probiotics have an effect on obesity, but the effectiveness and safety of only a few probiotics for the treatment of obesity have been reported. The purpose of this study was to investigate whether ingestion of Lactobacillus sakei (CJLS03) derived from kimchi causes weight loss in people with obesity.
Methods This randomized, double-blind, placebo-controlled, clinical trial involved 114 adults with a body mass index (BMI) ≥25 kg/m2 who were assigned randomly to a CJLS03 or placebo group. The groups received two allocations of either 5×109 colony-forming units of CJLS03/allocation or the equivalent vehicle for 12 weeks. Demographic and biochemical parameters, and body composition including fat and muscle mass were measured at baseline and after 12 weeks. Changes in body fat, weight, and waist circumference were compared between the two treatment groups. Adverse events were monitored during study period.
Results Body fat mass decreased by 0.2 kg in the CJLS03 group and increased by 0.6 kg in the placebo group (0.8 kg difference, P=0.018). After the 12 weeks, waist circumference was 0.8 cm smaller in the CJLS03 group than in the placebo group (P=0.013). BMI and body weight did not change after the 12 weeks. Adverse events were mild and did not differ between the two groups.
Conclusion These data suggest that L. sakei (CJLS03) might help people with obesity reduce body fat mass without serious side effects (ClinicalTrials.gov: NCT03248414).
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