Empagliflozin may improve nighttime blood sugar patterns in type 1 diabetes
Key takeaway:
In a small 8-week study of adults with type 1 diabetes, empagliflozin lowered HbA1c and appeared to improve nighttime glucose patterns while reducing insulin needs, without increasing time spent in low blood sugar.
Study at a glance
What was studied
Empagliflozin added to insulin in adults with type 1 diabetes using continuous glucose monitoring
Study type
non-randomized clinical trial (non-RCT or NRCT)
duration
Short-Term (≤3 mo)
Intervention
Empagliflozin
Outcomes
HbA1c, Blood glucose, Glucose variability, Time in range, Hypoglycemia events, Daily insulin dose
Funding
Industry sponsored
Main effects
HbA1c ↓ from 8.03% to 7.62% during treatment
Blood glucose patterns improved more at night than during the day
Total daily insulin dose ↓ by about 17%, mainly from lower basal insulin
Evidence Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Empagliflozin (Medications) |  Blood glucose (Glycemic Control) | Decrease | Mixed |
Empagliflozin (Medications) | Daily insulin dose (Glycemic Control) | Decrease | Strong |
Empagliflozin (Medications) | Glucose variability (Glycemic Control) | Decrease | Mixed |
Empagliflozin (Medications) | HbA1c (Glycemic Control) | Decrease | Mixed |
Empagliflozin (Medications) |  Hypoglycemia events (Safety) | Uncertain | Limited |
Empagliflozin (Medications) | Time in range (Glycemic Control) | Increase | Limited |
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Evidence Suggest
- Continuous glucose monitoring showed modest improvement during treatment and worsening after empagliflozin was stopped
- Nighttime glycemic exposure fell more than daytime exposure during treatment
- Time spent in low glucose did not clearly increase during treatment
Who this applies to
This study involved adults with type 1 diabetes who were normotensive and normoalbuminuric, with HbA1c between 6.5% and 11.0%. About two-thirds used insulin pumps and one-third used multiple daily injections. The findings may be most relevant to relatively young adults with uncomplicated type 1 diabetes receiving intensive insulin therapy.
Keep in Mind
This study does not prove that empagliflozin is broadly safe or effective for all people with type 1 diabetes. It was industry funded, open label, and exploratory. The paper also gives limited information here on uncommon but important risks such as ketoacidosis. Any use of this kind of therapy in type 1 diabetes needs careful clinical supervision and individualized insulin adjustment.
Between the Lines
- Single-arm open-label design with no control group
- Small sample size of 40 participants
- Most CGM findings were trends rather than strong between-period effects
- Short treatment and follow-up periods
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Journal Reference
Perkins BA, Cherney DZI, Soleymanlou N, et al. Diurnal Glycemic Patterns during an 8-Week Open-Label Proof-of-Concept Trial of Empagliflozin in Type 1 Diabetes. PLoS One. 2015;10(11):e0141085. doi:10.1371/journal.pone.0141085
Sources
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Key References
Most relevant evidence and guidance related to this research.
American Diabetes Association Standards of Care in Diabetes—2025
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