Empagliflozin therapy and insulin resistance-associated disorders: effects and promises beyond a diabetic state

Abstract

Empagliflozin is a SGLT2 inhibitor that has shown remarkable cardiovascular and renal activities in patients with type 2 diabetes (T2D). Preclinical and clinical studies of empagliflozin in T2D population have demonstrated significant improvements in body weight, waist circumference, insulin sensitivity, and blood pressure - effects beyond its antihyperglycaemic control. Moreover, several studies suggested that this drug possesses significant anti-inflammatory and antioxidative stress properties. This paper explores extensively the main preclinical and clinical evidence of empagliflozin administration in insulin resistance-related disorders beyond a diabetic state. It also discusses its future perspectives, as a therapeutic approach, in this high cardiovascular-risk population.

Keywords: empagliflozin; insulin resistance; metabolic syndrome; obesity.

Figure 1

Empagliflozin and WAT: possible mechanisms to suppress an overweight/obese non-diabetic insulin-resistant state. M – macrophages, CYT – cytokines, CHEM – chemokines, T – T lymphocytes, NLRP-3 – nucleotide-binding domain, leucine-rich repeat containing protein, mTOR – mammalian target of rapamycin, NEFAs – non-esterified fatty acids, WAT – white adipose tissue.