What question did this study set out to answer?

To determine whether the SGLT2 inhibitor empagliflozin reduces arterial stiffness and sympathetic nervous system activity during clamped euglycaemic and hyperglycaemic conditions in type 1 diabetes.

January 1, 2014Cardiovascular DiabetologyOpen Access

The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus

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Why the study?

Does empagliflozin improve arterial stiffness and heart rate variability in normotensive patients with type 1 diabetes mellitus?

Population

40 normotensive patients with uncomplicated type 1 diabetes mellitus

Design

Cohort

Follow-up

8 weeks

Authors

DCDavid Z.I. CherneyUniversity of Notre Dame BPBruce A. PerkinsSinai Health System NSNima SoleymanlouBoehringer Ingelheim (United States)

Discussion

Member takes

Implication

May indicate vascular benefits in normotensive T1DM independent of glycaemia; hypothesis-generating and should not yet change practice.

Key Points

To determine whether the SGLT2 inhibitor empagliflozin reduces arterial stiffness and sympathetic nervous system activity during clamped euglycaemic and hyperglycaemic conditions in type 1 diabetes.
Interventional clinical trial (NCT01392560) in N=40 normotensive patients with uncomplicated type 1 diabetes mellitus.
Measured blood pressure, arterial stiffness, heart rate variability, and adrenergic mediators during clamped euglycaemia (4–6 mmol/L) and hyperglycaemia (9–11 mmol/L) at baseline and after 8 weeks of empagliflozin (25 mg daily).
Under euglycaemic clamp, empagliflozin reduced systolic blood pressure (111 ± 9 to 109 ± 9 mmHg, p = 0.02) and radial (-52% ± 16 to -57% ± 17, p = 0.0001), carotid (+1.3 ± 17.0 to -5.7 ± 17.0%, p < 0.0001), and aortic augmentation indices (+0.1 ± 13.4 to -6.2 ± 14.3%, p < 0.0001).
Carotid-radial pulse wave velocity decreased across both glycemic states (p ≤ 0.0001), and carotid-femoral pulse wave velocity declined during hyperglycaemia (5.7 ± 1.1 to 5.2 ± 0.9 m/s, p = 0.0017).
Heart rate variability, plasma noradrenaline, and adrenaline levels remained unchanged across both clamped conditions.

Structured PICO

Does empagliflozin improve arterial stiffness and heart rate variability in normotensive patients with type 1 diabetes mellitus?

Population

40 normotensive patients with uncomplicated type 1 diabetes mellitus

Intervention

Empagliflozin 25 mg once daily for 8 weeks

Outcome

Blood pressure, arterial stiffness (augmentation indices and pulse wave velocity), heart rate variability (HRV), and circulating adrenergic mediators during clamped euglycaemia and hyperglycaemiasurrogate

Empagliflozin reduces arterial stiffness and systolic blood pressure in normotensive patients with type 1 diabetes, suggesting potential vascular benefits beyond glucose lowering.

Cite This Study

Cherney et al. (2014) studied this question.

synapsesocial.com/papers/6a0289d8a7089d64356508f2 https://doi.org/10.1186/1475-2840-13-28

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The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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