Vaduganathan M, Inzucchi SE, Sattar N, et al. - The findings revealed that empagliflozin markedly and durably delays insulin initiation and substantial increases in insulin dose while facilitating sustained reductions in insulin requirements over time in patients with type 2 diabetes and cardiovascular disease.

• Empagliflozin decreased new use of insulin vs. placebo by 60% (7.1% vs. 16.4%; adjusted HR 0.40 [95% CI 0.32-0.49]; P<0.0001) in 3,633 (52%) participants not treated with insulin at baseline.

• The results showed that in 3,387 (48%) patients using insulin at baseline, empagliflozin decreased need for a >20% insulin dose increase by 58% (14.4% vs. 29.3%; adjusted HR 0.42 [95% CI 0.36-0.49]; P<0.0001) and elevated the proportion achieving sustained >20% insulin dose reductions without subsequent increases in HbA1c compared with placebo (9.2% vs. 4.9%; adjusted HR 1.87 [95% CI: 1.39-2.51]; P<0.0001).

• The data indicated that when insulin dose changes >10% or >30% were considered, sensitivity analyses confirmed consistent findings.