COMPARISON OF GLYCEMIC CONTROL USING COMBINATION OF EMPAGLIFLOZIN WITH METFORMIN VERSUS SITAGLIPTIN WITH METFORMIN

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) has been a major health issue in Pakistan which needs combination therapy as metformin monotherapy fails. The purpose of the study was to compare the glycemic efficacy of the Empagliflozin and Sitagliptin as an add-on to Metformin in a local clinical context. Methods: The randomized controlled trial conducted in the Medicine Department of the Combined Military Hospital (CMH) in Abbottabad from 3rd December 2025 to 3rd April 2026. Using non-probability consecutive sampling technique, 60 patients who had poorly controlled T2DM and were on metformin baseline therapy were randomly assigned in two groups (n=30, each). Group A was treated with Sitagliptin (50 mg twice a day) and Group B had Empagliflozin (10 mg once a day) along with Metformin (1,000mg/day). The main outcome was change in HbA1C at 12 weeks from the baseline values. The SPSS version 25.0 was used to analyze the data. Results: The mean age of participants was 41.73±13.38 years. After 12 weeks, the mean reduction in HbA1C was significantly greater in the Empagliflozin group (-1.18±0.25) compared to the Sitagliptin group (-0.86±0.17), with a statistically highly significant difference (p< 0.001). Stratification analysis confirmed the superior efficacy of Empagliflozin was consistent across age, gender, BMI, and duration of diabetes. Both treatments were well-tolerated with no major adverse events. Conclusion: The use of Empagliflozin and Metformin as a combination has better glycemic control than the use of Sitagliptin and Metformin in patients with poorly controlled T2DM. These results indicate that Empagliflozin could be a better second-line intervention in the Pakistani diabetic population.