4.7 Article

Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction

Journal

DIABETES CARE
Volume 45, Issue 5, Pages 1247-1251

Publisher

AMER DIABETES ASSOC
DOI: 10.2337/dc21-2434

Keywords

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Funding

  1. National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases [R01-DK123259, R01DK033823]
  2. National Heart, Lung, and Blood Institute [R01-HL146691, R01-HL159062, T32-HL144456]
  3. National Institute on Aging [R56-AG066431]
  4. Diabetes Action Research and Education Foundation
  5. American Heart Association [AHA-20POST35211151]
  6. Irma T. Hirschl and Monique Weill-Caulier Trusts

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This study demonstrates the significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF. The results show improvements in cognitive function as well as physical impairment in the empagliflozin group compared to the metformin and insulin groups.
OBJECTIVE To assess whether the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin improves cognitive impairment in frail older adults with diabetes and heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS We designed a prospective study to assess cognitive and physical function in consecutive frail older adults with diabetes and HFpEF, comparing the effects of empagliflozin, metformin, and insulin. RESULTS A total of 162 frail older adults with HFpEF and diabetes successfully completed the study. Montreal Cognitive Assessment scores at baseline and after 1 month were 19.80 +/- 3.77 vs. 22.25 +/- 3.27 (P < 0.001) in the empagliflozin group, 19.95 +/- 3.81 vs. 20.71 +/- 3.56 (P = 0.26) in the metformin group, and 19.00 +/- 3.71 vs. 19.1 +/- 3.56 (P = 0.81) in the insulin group. A multivariable regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-m gait speed test, in the empagliflozin and metformin groups but not in the insulin group. CONCLUSIONS This study is the first to show significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF.

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