TABLE 2.
Changes in myocardial glucose metabolic rate, insulin sensitivity, glucose and insulin concentrations and myocardial oxygen consumption during 18F‐FDG‐PET combined with euglycaemic‐hyperinsulinaemic clamp after exposure to empagliflozin or glimepiride for 26 weeks
| Empagliflozin n = 23 | Glimepiride n = 23 | Adjusted difference between groups (95% CI) | P value | P value a | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Before treatment | After 26 weeks of treatment | Treatment difference | P value | Before treatment | After 26 weeks of treatment | Treatment difference | P value | |||||
| Myocardial MrGlu (μmol/min/100 g) | 14.4 ± 9 | 7.9 ± 8 | −6.55 ± 6.4 | <.0001 | 10.3 ± 9 | 13.8 ± 10 | 3.49 ± 5.8 | .01 | −6.07 | (−8.59, −3.55) |
<.0001 |
.001 |
| Insulin‐stimulated glucose disposal corrected for FFM and urinary glucose loss (mg/min × kg FFM) | 3.49 ± 2 | 5.52 ± 2.1 | 2.02 ± 2.2 | <.0001 | 5.5 ± 3.4 | 3.97 ± 2.4 | −1.53 ± 2.1 | .003 | 1.53 | (0.73, 2.33) |
<.0001 |
<.0001 |
| Fasting plasma glucose concentration at the beginning of the clamp (mg/dl) | 120 ± 24 | 111 ± 16 | −9.56 ± 21 | .04 | 112 ± 21 | 106 ± 16 | −6.52 ± 15 | .052 | −7.35 | (−13.1, −1.59) |
.7 |
– |
| Plasma glucose concentration at the end of the clamp (mg/dl) | 101 ± 6 | 99 ± 2 | −1.9 ± 4 | .055 | 101 ± 4 | 99 ± 1 | −1.69 ± 4 | .055 | ‐1.69 | (−4.32, −2.5) |
.9 |
– |
| Fasting plasma insulin levels at the beginning of the clamp (mU/ml) | 11.2 ± 5.9 | 8.4 ± 5.8 | −2.87 ± 2.5 | <.0001 | 10.8 ± 7 | 12 ± 6 | 1.75 ± 5.4 | .2 | −2.83 | (−4.56, −1.09) |
.001 |
.002 |
| Steady state plasma insulin levels during the clamp (mU/ml) | 50.9 ± 23 | 48.6 ± 26 | −2.3 ± 15 | .2 | 50.03 ± 26 | 47.4 ± 18 | −2.63 ± 9 | .2 | −1.7 | (−8.6, 5.2) |
.9 |
.8 |
| MVO2 during the clamp (mmHg*bpm) | 9777 ± 1915 | 8536 ± 1359 | −1240 ± 1678 | .002 | 9001 ± 1694 | 9685 ± 2140 | 684 ± 793 | <.0001 | −1666 | (−2283, −948) | <.0001 | – |
Note: Data are means ± SD, unless otherwise indicated, and were analysed using ANCOVA adjusting for baseline values. Changes in individual outcomes during the intervention period and effects of the treatment were modelled by linear mixed‐effects models.
Abbreviations: 18F‐FDG‐PET, 18F‐fluorodeoxyglucose‐positron emission tomography; BMI, body mass index; FFM, fat‐free mass; MrGlu, glucose metabolic rate; MVO2, myocardial oxygen consumption.
Adjusted for changes in BMI.