The prevalence of type 2 diabetes is increasing rapidly and represents a major risk factor for cardiovascular disease.\u00a0 Although glycemic control has been shown to reduce microvascular complications, the effect of glycemic control on macrovascular disease is more limited.\u00a0 Furthermore, some glucose lowering drugs have been associated with worse cardiovascular outcomes.\u00a0 Accordingly, ensuring the cardiovascular safety of new diabetic therapies is important. Empaglifozin is one of the first in a new class of drugs that lowers serum glucose levels by decreasing renal glucose reabsorption.\u00a0 In this study of 7020 patients at high risk of cardiovascular events, patients were randomized to one of two doses of empagliflozin (10 mg or 25 mg) or placebo, as well as standard guideline based diabetic therapy.\u00a0 The primary outcome was a composite of major adverse cardiovascular events or cardiovascular death.\u00a0 Although powered as a non-inferiority study, empaglifozin demonstrated statistical superiority as add-on diabetic therapy, significantly reducing the incidence of the primary end-point (10.5% vs. 12.1%, HR 0.86; 95% CI, 0.74 to 0.99; P=0.04 for superiority), including a significant reduction in the risk of death (5.7% and 8.3%, respectively; 32% relative risk reduction).\u00a0 Use of empaglifozin increased the rates of genital infection (although UTI rates were similar), presumably secondary to the increased amount of glucose present in urine.\u00a0 No other adverse events were increased with use of empaglifozin.<\/p>\n
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