From the Guidelines
Jardiance (empagliflozin) is not specifically approved or recommended for treating neuropathy pain, and instead, medications like gabapentin, pregabalin, duloxetine, or amitriptyline are recommended for neuropathy pain management. These medications work directly on pain pathways in the nervous system, as suggested by the American Academy of Neurology guidelines 1. While controlling blood sugar with Jardiance may indirectly help prevent worsening of diabetic neuropathy over time, it does not provide direct pain relief for existing neuropathic pain.
Key Points to Consider
- The American Academy of Neurology recommends gabapentinoids, serotonin-norepinephrine reuptake inhibitors (SNRIs), sodium channel blockers, tricyclic antidepressants (TCAs), and SNRI/opioid dual-mechanism agents for the treatment of pain in diabetic peripheral neuropathy (DPN) 1.
- A recent guideline suggests that the initial treatment of pain should also focus on the concurrent treatment of both sleep and mood disorders because of increased frequency of these problems in individuals with DPN 1.
- Medications such as pregabalin, duloxetine, or gabapentin are recommended as initial pharmacologic treatments for neuropathic pain in diabetes, as stated in the standards of medical care in diabetes-2019 and 2021 1.
Treatment Approach
For neuropathy pain management, it's essential to discuss treatment options with a healthcare provider, who can recommend appropriate pain management strategies based on individual needs. The connection between Jardiance and neuropathy relates to its role in diabetes management - by improving blood sugar control, it may help prevent the nerve damage that leads to diabetic neuropathy, but this is a preventive effect rather than a treatment for existing pain.
From the Research
Jardiance and Neuropathy Pain
- Jardiance, also known as empagliflozin, is a medication used to treat type 2 diabetes mellitus 2.
- Research suggests that empagliflozin may have a neuroprotective effect and could be a promising therapeutic agent for diabetic peripheral neuropathy 3.
- A study found that empagliflozin improved electrophysiological studies and decreased the brief pain inventory short-form item (BPI-SF) score in patients with diabetic peripheral neuropathy 3.
- Another study found that empagliflozin mitigated type 2 diabetes-associated peripheral neuropathy through a glucose-independent effect via AMPK signaling 4.
Mechanism of Action
- Empagliflozin works by inhibiting the sodium glucose cotransporter-2 (SGLT2) 2.
- The medication has been shown to modulate the AMPK pathway, reducing oxidative and inflammatory burden, extracellular matrix remodeling, and autophagy 4.
- Empagliflozin has also been found to upregulate p-AMPK, reduce p-p38 MAPK expression, and enhance SOD activity 4.
Current Treatments for Neuropathy Pain
- Current treatments for diabetic neuropathy focus on preventative care and pain management 5.
- The United States Food and Drug Administration (FDA) has confirmed four drugs for painful diabetic neuropathy: pregabalin, duloxetine, tapentadol, and the 8% capsaicin patch 5.
- Nonpharmacological treatments such as spinal cord stimulation (SCS) and transcutaneous electrical nerve stimulation (TENS) have also shown promise in reducing pain in diabetic patients 5.