Moosaie Fatemeh, Abedinzadeh Shiva, Rabizadeh Soghra, Daneshvar Kimia, Noorafrooz Mohammadamin, Mojtahedi Fatemeh Alsadat, Deravi Niloofar, Fatemi Abhari Seyede Marzie, Ramezani Akam, Meysamie Alipasha, Hajibabaei Marzieh, Reyhan Sahar Karimpour, Abbaszadeh Mahsa, Nakhjavani Manouchehr, Esteghamati Alireza
Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, P.O. Box: 13145-784, Tehran, Iran.
International Surgical Research Association (ISRA), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2025 Jan 9;15(1):1427. doi: 10.1038/s41598-024-84993-x.
The management of Type-2 Diabetes Mellitus (T2DM) remains challenging in cases of poor glycemic control despite triple Oral Hypoglycemic Agent (OHA) therapy. This prospective cohort study aimed to assess the effectiveness of Empagliflozin as part of a quadruple OHA regimen over a 7-year follow-up period in 575 adult patients with uncontrolled T2DM on a triple OHA regimen and who were unwilling to initiate insulin therapy. Overall, 92.5% of patients achieved their target HbA1c levels. Significant reductions were observed in all glycemic parameters after 68 months (p < 0.001). Weight and BMI significantly decreased, whereas waist circumference remained unchanged. Lipid profiles showed significant improvements in total cholesterol, LDL, and triglycerides, while HDL levels did not change significantly. Blood pressure trends revealed significant reductions in both diastolic blood pressure (DBP) and mean arterial pressure (MAP), though systolic blood pressure (SBP) remained relatively stable. Our study indicates that adding empagliflozin to a drug regimen consisting of multiple OHAs can effectively control glycemia in T2DM patients with more pronounced target achievement (< 7%) and HbA1c reduction along with improvement in cardiometabolic parameters, suggesting its potential as a promising alternative for long-term glycemic management.
尽管采用三联口服降糖药（OHA）治疗，但在血糖控制不佳的2型糖尿病（T2DM）病例中，其管理仍然具有挑战性。这项前瞻性队列研究旨在评估在7年的随访期内，恩格列净作为四联OHA方案一部分，对575例接受三联OHA方案治疗且不愿开始胰岛素治疗的成年T2DM控制不佳患者的有效性。总体而言，92.5%的患者达到了目标糖化血红蛋白（HbA1c）水平。68个月后，所有血糖参数均显著降低（p<0.001）。体重和体重指数（BMI）显著下降，而腰围保持不变。血脂谱显示总胆固醇、低密度脂蛋白（LDL）和甘油三酯有显著改善，而高密度脂蛋白（HDL）水平无显著变化。血压趋势显示舒张压（DBP）和平均动脉压（MAP）均显著降低，尽管收缩压（SBP）保持相对稳定。我们的研究表明，在由多种OHA组成的药物方案中添加恩格列净，可以有效控制T2DM患者的血糖，更显著地实现目标（<7%）并降低HbA1c，同时改善心脏代谢参数，表明其作为长期血糖管理的一种有前景的替代方案的潜力。
