Effect of Empagliflozin Combination Therapy on Elderly Patients with Type 2 Diabetes Mellitus Complicated with Acute Heart Failure

WU Jiahong; WANG Tao; ZHANG Youtao; ZUO Li; YANG Xiaomin; ZHANG Qian; DONG Li-ping

doi:10.3969/j.issn.1002-3429.2025.08.008

Abstract：Objective To investigate the effect of Empagliflozin combination therapy on elderly patients with type 2 diabetes mellitus(T2DM)complicated with acute heart failure(AHF).Methods A total of 166 elderly patients with T2DM and AHF from January 2023 to July 2023 were selected and randomly divided into two groups,with 83 patients in each group.The control group was given conventional treatment,and the observation group was treated with Empagliflozin on the basis of the control group.Both groups were treated for one week,and the clinical efficacy of the two groups was compared.Blood glu-cose levels[fasting plasma glucose(FBG),2-hour postprandial plasma glucose(2 h PG)],cardiac function indexes[cardi-ac output(CO),left ventricular ejection fraction(LVEF),B-type natriuretic peptide(BNP),left ventricular end-diastolic diameter(LVDD)],renal function indexes[urinary albumin to creatinine ratio(UACR),estimated glomerular filtration rate(eGFR),dosage of Furosemide],P38 MAPK signaling pathway-related protein expression before and after treatment,appli-cation safety,and prognosis at 1-year follow-up were compared between the two groups.Results The total effective rate of the observation group was 96.39%(80/83),which was higher than87.95%(73/83)of the control group,showing signifi-cant difference(P＜0.05).After treatment,the 2 h PG and FBG levels of the two groups were decreased,which were lower in the observation group than in the control group(P＜0.05,P＜0.01).After treatment,LVEF and CO were increased,LVDD and BNP were decreased in the two groups,and the increase of LVEF and CO and the decrease of LVDD and BNP in the observation group were greater than those in the control group(P＜0.05,P＜0.01).After treatment,UACR was de-creased,while eGFR was increased in the two groups;eGFR in the observation group was higher than that in the control group,while UACR and dosage of Furosemide were lower than those in the control group(P＜0.05,P＜0.01).After treat-ment,the levels of p-ERK,p-P38 and p-JNK in the two groups were lower than those before treatment,which were lower in the observation group than in the control group(P＜0.05,P＜0.01).During treatment,the incidence of acute kidney injury in the observation group was lower than that in the control group(P＜0.05),and there was no significant difference in the in-cidence of urinary tract infection and hypotension between the two groups(P＞0.05).After 1 year of follow-up,there was no significant difference in survival rate between the two groups(P＞0.05),and the rehospitalization rate of heart failure in the observation group was lower than that in the control group(P＜0.05).Conclusion Empagliflozin combination therapy has a significant effect in the treatment of elderly T2DM patients with AHF,which can reduce blood glucose levels,alleviate renal function damage,improve cardiac function and short-term prognosis,inhibit the expression of P38 MAPK signaling pathway related proteins,and has high safety.