Combining SGLT2 inhibitors with insulin therapy: Impact on cardiovascular outcomes in patients with diabetes-induced endocrine disorders

This observational, comparative study aimed to evaluate the impact of combining sodium-glucose cotransporter-2 (SGLT2) inhibitors with insulin therapy in patients with diabetes-induced endocrine disorders over 12 months. A total of 160 adult patients diagnosed with complications such as diabetic nephropathy, cardiomyopathy and autonomic neuropathy were enrolled between 2023 and 2024. Participants were divided into two groups: One receiving combination therapy (SGLT2 inhibitors with insulin) and the other receiving insulin monotherapy. Clinical data were collected at baseline, and at 3, 6, 9 and 12 months, focusing on glycemic indices, renal and cardiovascular function, metabolic health, and quality of life. The combination therapy group demonstrated significant reductions in HbA1c, fasting and postprandial blood glucose levels. Renal function improved with increased estimated glomerular filtration rate (eGFR) and decreased albumin-to-creatinine ratio (ACR). Cardiovascular benefits included fewer major adverse cardiac events, reduced heart failure hospitalizations and lower NT-proBNP levels. Metabolic health showed better BMI control and improved lipid profiles (lower LDL, triglycerides, and higher HDL). Quality of life scores were significantly higher in the combination group. Overall, the combined therapy proved superior in managing glycemic control and mitigating diabetes-related complications, suggesting its potential as an effective, comprehensive treatment strateg.