Empagliflozin, metformin and insulin degludec, during pregnancy: a case report
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In the last 10 years, several new oral hypoglycemic agents and novel insulin analogs have been introduced for type 2 diabetes therapy which demonstrated to be a valid and safety support in terms of blood glucose and weight control as well as cardiovascular protection. Among them, empagliflozin, by inhibiting the sodium-glucose co-transporter 2 (SGLT-2) at the proximal convoluted tubule level, decreases renal glucose reabsorption and favors calories loss. Insulin degludec is an extra-long-acting insulin analog associated with reduced glycemic variability and reduced hypoglycemic events as compared to glargine. Metformin, in use since many years for diabetes treatment, is a biguanide lowering blood glucose by reducing hepatic glucose output, increasing insulin sensitivity and enhancing peripheral glucose uptake. In Italy, none of these drugs is approved for use during pregnancy.
In animal studies, empagliflozin treatment has shown no direct or indirect detrimental effects on...
KeywordsPregnancy Diabetes Therapy Metformin Empagliflozin Degludec
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Conflict of interest
A.C. has received speaker fees and/or consulting honoraria from Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Roche Diagnostics, Sanofi-Aventis, Takeda and has received research grant support from Eli Lilly and Novo Nordisk. G.F. has received speaker fees from Eli Lilly, Merck Sharp & Dohme, Menarini Diagnostics and Servier. F.G. and G.D.D. have received nothing.
The study was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from the patient included in the case report.
- 4.Highlights of prescribing information, Jardiance n.d. http://docs.boehringer-ingelheim.com/PrescribingInformation/PIs/Jardiance/jardiance.pdf