The impact of increased hepatic glucose production caused by empagliflozin on plasma glucose concentration in individuals with type 2 diabetes and nondiabetic individuals
Authors' conclusion
The balance between UGE and increase in HGP immediately after sodium-glucose cotransporter-2 (SGLT2) inhibition determined the magnitude of decrease in FPG and the new steady state which was achieved. After 12 weeks, the increase in HGP caused by empagliflozin closely matched the amount of glucose excreted by the kidneys; thus, FPG level remained stable despite the continuous urinary excretion of glucose caused by SGLT2 inhibition.
Study context
- Population
- Individuals with T2D and nondiabetic individuals (n=34; normal or impaired glucose tolerance)Individuals with T2D 36
- Comparison
- Empagliflozin vs placebo
- Primary endpoint
- Impact of increased hepatic glucose production (HGP) on the decrease in plasma glucose caused by empagliflozin; HGP measured with 3-3H-glucose infusion after overnight fast
- Follow-up
- Before, at start of, and 3 months after therapy
Methodological detailsdouble-blind, placebo-controlled, 2:1 randomization
- Double-blind
- Placebo-controlled
- 2:1 randomization
Primary result
As reported in the abstract
UGE, HGP and FPG with empagliflozin · Day 1
- Increase in urinary glucose excretion (UGE) smaller with normal glucose tolerance than with impaired glucose tolerance or diabetes; accompanied by increase in hepatic glucose production (HGP) in all three groups
- Glucose returned by increased HGP smaller than UGE during first 3 h, resulting in decrease in fasting plasma glucose (FPG)
- After 3 h, HGP increase exceeded UGE, leading to small increase in plasma glucose reaching a new steady state
Further findings
HGP increase vs UGE · 12 weeks
- Glucose returned by empagliflozin-induced HGP increase comparable with UGE in all three groups
Original publication
The impact of increased hepatic glucose production caused by empagliflozin on plasma glucose concentration in individuals with type 2 diabetes and nondiabetic individuals. Diabetes Obes Metab. Published 22 December 2023. doi:10.
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