From the Guidelines
Jardiance (empagliflozin) is not currently FDA-approved for prediabetes and should only be used in patients with type 2 diabetes or other specific indications like heart failure or chronic kidney disease for which it is approved. The standard approach for prediabetes management remains lifestyle modifications, including weight loss of 5-7% of body weight, 150 minutes of physical activity weekly, and a healthy diet, as recommended by the 2018 standards of medical care in diabetes 1. While some research suggests SGLT2 inhibitors like Jardiance might have benefits in prediabetes by improving insulin sensitivity and promoting weight loss, clinical guidelines do not recommend its use for prediabetes management. Metformin may be considered in high-risk individuals with prediabetes (BMI ≥35 kg/m², age <60 years, or women with prior gestational diabetes) 1. The use of SGLT2 inhibitors, including empagliflozin, has been shown to reduce the risk of cardiovascular events and heart failure hospitalization in patients with type 2 diabetes and established cardiovascular disease or at high risk of cardiovascular events, as noted in the 2020 ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases 1 and the 2022 standards of medical care in diabetes 1. However, these benefits do not extend to the management of prediabetes, and empagliflozin should not be used off-label for this indication without strong clinical evidence supporting its use. Key considerations in managing prediabetes include identifying and treating other cardiovascular risk factors, such as obesity, hypertension, and dyslipidemia, and providing education and support for lifestyle modifications, as outlined in the 2015 standards of medical care in diabetes 1. In summary, the use of Jardiance (empagliflozin) in patients with prediabetes is not recommended outside of clinical trials or specific approved indications, and lifestyle modifications and metformin, when appropriate, remain the cornerstone of prediabetes management.
From the Research
Indication of Jardiance (Empagliflozin) in Patients with Prediabetes
- There are no research papers to assist in answering this question, as none of the provided studies mention Jardiance (Empagliflozin) or its indication in patients with prediabetes 2, 3, 4, 5, 6.
Alternative Treatments for Prediabetes
- Metformin may be considered as a treatment option for children and adolescents with prediabetes who have not responded to lifestyle changes 3.
- Physical activity intervention has been shown to have a favorable effect on improving oral glucose tolerance, fasting blood sugar, glycated hemoglobin (HbA1C), maximum oxygen uptake (VO2max), and body composition in individuals with prediabetes 6.
Treatment Options for Type 2 Diabetes
- Metformin is commonly used as a first-line treatment for type 2 diabetes, but its use as the initial therapy for all patients with diabetes is being re-evaluated due to the emergence of more effective agents 2, 5.
- Glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 inhibitors have demonstrated significant positive effects on glycemia and may be considered as first-line therapy for patients with type 2 diabetes who would benefit from cardio-renal protection 2, 4, 5.