Metabolic and renal outcomes of empagliflozin in patients with type 2 diabetes mellitus attending Armed Forces Hospital in Saudi Arabia: Retrospective cohort study

OBJECTIVES

To explore the effects of empagliflozin (25 mg) on metabolic and renal parameters in patients with type 2 diabetes mellitus (T2DM).

METHODS

This retrospective observational comparative study was conducted at a military hospital in southern Saudi Arabia. All adults (aged >18 years) with T2DM who attended diabetic clinics between October 2021 to March 2022 (6 months), with or without insulin treatment, were eligible for inclusion in the study.

RESULTS

Following the initiation of empagliflozin treatment, statistically significant reductions in patient weight (kg) were observed at 1, 3-5, and 6 months. In addition, low-density lipoprotein levels significantly decreased 3-5 months post-treatment initiation (p=0.011). However, serum creatinine level decreased gradually with time during the treatment with empagliflozin, from 87.45±31.78 (0.105) to 78.39±27.43 (0.033). Furthermore, after empagliflozin treatment, the urinary albumin-to-creatinine ratio significantly decreased at 3-5 and 6 months. Moreover, HbA1c levels exhibited statistically significant decreases at 3-5 months (p<0.001) and at 6 months (p<0.001) following the initiation of empagliflozin treatment. Notably, systolic and diastolic blood pressure significantly reduced 6 months after empagliflozin treatment.

CONCLUSION

In the current study, empagliflozin has demonstrated efficacy in controlling blood pressure and body weight, and improving renal function, short-term dyslipidemia, and glycemic control in patients with T2DM.

Effect of type 2 diabetes mellitus in adults undergoing fixed orthodontic treatment on proinflammatory chemokine profile and levels of advanced glycation in gingival crevicular fluid

OBJECTIVE

The current study aims to reconnoiter the outcome of diabetes mellitus type 2 (DMT2) on levels of advanced glycation end products (AGEs) and pro-inflammatory chemokine in gingival crevicular fluid (GCF) of individuals undergoing fixed orthodontic treatment.

PATIENTS AND METHODS

Participants were divided into a diabetic and no-diabetic group according to inclusion and exclusion criteria. Power analysis was adopted from a previous study that reported GCF chemokines in obese individuals. All teeth were measured for clinical periodontal parameters (CPP). GCF and saliva were collected 3 months after placing stainless steel archwire. GCF was investigated for pro-inflammatory cytokines all expressed in pg/mL. Quantification of chemokines was performed using a Magnetic bead-based multiplex assay for the Luminex® platform. Non-normality of data was assessed by Mann-Whitney U-test. Normality was estimated using an Independent t-test. Descriptive data were computed in the form of standard deviations and means.

RESULTS

Unstimulated whole saliva flow rate (UWSFR) was significantly lower in diabetic patients compared to non-diabetics (p=.021). Amongst different clinical periodontal parameters (CPP) no difference in plaque scores (PS) and probing depth (PD) was found between diabetic and non-diabetic participants. Two GCF chemokines i.e., Resistin (p=.031) and AGEs (p=.017) were observed to be significantly higher in DMT2 participants compared to the non-diabetes group. CPP and GCF biomarkers in diabetic and non-diabetic individuals demonstrated a positive correlation between AGEs and GCF resistin levels concerning bleeding on probing (BoP) in diabetic patients.

CONCLUSIONS

Participants with DMT2 after alignment with an orthodontic device exhibited significantly high levels of resistin and AGEs. The proinflammatory response was noted in patients with hyperglycemia undergoing orthodontic treatment.