Endocrinologists Hesitant to Believe Empagliflozin Reduces Cardiac Events and Deaths

Larry Husten covers the issue at his blog. Click the link below for details. I’m in the endocrinology camp on this one. A quote from Mr. Husten’s post:

“An observer came away from the meeting with the strong impression that the endocrinologists did not want to accept any evidence that empagliflozin could reduce the risk of cardiovascular death; were not prepared to acknowledge that drugs might work in diabetes by effects that were independent of blood glucose; and wanted to be left in peace to be allowed to micromanage hemoglobin A1c without being reminded that doing so does not change the cardiovascular risk of patients with diabetes.”

Source: Prominent Cardiologists Decry Tepid Support For Empagliflozin By Endocrinologists


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2 responses to “Endocrinologists Hesitant to Believe Empagliflozin Reduces Cardiac Events and Deaths

  1. “2.6% absolute … risk reduction in ACM [all-cause mortality] and 2.2% absolute … risk reduction in CVM (cardiovascular mortality)” – pathetic really – correct me if I’m wrong, but doesn’t the absolute risk reduction from bringing HbA1c out of the diabetic zone with a lowcarb diet dwarf these puny figures?

    • JC, part of my hesitancy to endorse empagliflozin is that I see no plausible explanation on a physiologic level why it would reduce cardiac deaths or events. IIRC, the purported benefit was seen irrespective of hemoglobin A1c lowering.
      Unfortunately, we don’t have great hard data on mortality and morbidity reduction via longterm low-carb eating. Obviously, I think it’s effective, but I’d love to see a 5-10 year-long randomized controlled trial to prove it.