At 24 weeks, patients on metformin plus empagliflozin (Jardiance) 10mg daily lost 2.5% of their body weight. Patients on metformin plus 25 mg lost 2.9% and patients on metformin alone lost 0.5%. That is meaningful weight loss in a short period of time simply based on medication choices for diabetes.
On the other hand, patients who start insulin for type 2 diabetes consistently gain weight. Within 12 months of starting long-acting and mealtime insulin together, 35% of patients gained 22 pounds or more. Another 29% gained 11 to 22 pounds. Nearly two third of patients gained substantial amounts of weight compared to weight loss with metformin and empagliflozin. Type 2 diabetes is a weight disease. Weight gain makes the blood pressure and cholesterol harder to control. Our therapeutic approach to glucose control makes a huge difference. It is important to severely restrict glucose intake, restrict carb intake, and then add metformin for poor glucose control. If control is still not adequate, continue to press on diet. If still, not controlled, add a medication like empagliflozin. If the sugar is still high, add self-adjusted basal insulin. Do what you can to slow progression to long-acting and mealtime insulin because those people don’t do well. Too often providers are causing weight gain.
THAT's interesting. I looked quick to see what Empagliflozin is - my quick search said it treats DM2 and heart failure with reduced ejection fractio?. Hm! t's still on patent?