Vaduganathan M, Inzucchi SE, Sattar N, et al. - In patients with type 2 diabetes and cardiovascular disease, researchers examined how empagliflozin vs placebo influences subsequent insulin initiation or dosing changes.

• A total of 7,020 patients received empagliflozin 10 mg, 25 mg, or placebo in EMPA-REG OUTCOME.

• There were 3,633 (52%) participants who were not receiving insulin treatment at baseline; in these patients, empagliflozin led to a reduction in new use of insulin vs placebo by 60%.

• A total of 3,387 (48%) patients were using insulin at baseline; empagliflozin use in these patients lowered the necessity for a greater than 20% insulin dose increase by 58% and increased the proportion achieving sustained greater than 20% insulin dose reductions without subsequent increases in HbA1c compared with placebo (9.2% vs. 4.9%).

• Overall, insulin initiation and substantial increases in insulin dose are markedly and durably delayed when empagliflozin is provided, with attainment of sustained reductions in insulin requirements over time.