Diabetes is one of the leading causes of death in the world. According to the World Health Organization, approximately 422 million people are living with diabetes.
Although the diabetes is prominent in lower and middle-income countries, it is one of the most common diseases that affect Americans as well. Based on statistics collected by the Centers for Disease Control and Prevention (CDC), diabetes currently affects about 34.2 million people in the United States. Including pre-diabetes, a condition that predisposes an individual to the development of diabetes, a staggering 122 million people are living with some form of a diabetic condition.
Diabetes is characterized by the body’s inability to process blood sugar causing the accumulation of high blood glucose levels.
This is due to the inability of the special cells within the pancreas to produce the hormone, insulin, which is normally responsible for transport of glucose out of the blood and to cells where it is utilized for regular processes such as conversion into energy.
The two major types of diabetes are type 1 and type 2. In both types, the pancreas has impaired ability to produce insulin causing high blood sugar.
Type 1 diabetes is an autoimmune condition in which the body cannot produce insulin at all because the immune system attacks the pancreas making it unable to produce functional insulin.
This type of diabetes is also called ‘insulin-dependent diabetes’ and is most often diagnosed at a young age.
In contrast, type 2 diabetes is also called ‘non-insulin dependent diabetes’ and is almost always diagnosed in adulthood with a larger percentage developing the condition after the age of 65.
In type 2 diabetes, some amount of insulin can be produced by the pancreas, but it is either not enough to keep blood sugar at a normal level or it cannot be used in the proper way to maintain blood sugar levels.
How is diabetes treated?
Both types of diabetes can be dangerous if left untreated.
There is no cure for diabetes, and without managing the disease it can lead to serious health complications. Some of the major health consequences caused by diabetes include:
- Cardiovascular disease (heart Disease or heart attack)
- Stroke
- Eye damage (diabetic retinopathy)
- Nerve damage (diabetic neuropathy)
- Kidney damage (diabetic nephropathy)
- Impaired wound healing
Treatment of diabetes includes a combination of prescription drugs along with changes in diet and implementing an exercise regimen.
Diabetes is a life long condition once diagnosed, so following a recommended treatment plan that includes all of these factors is extremely important in keeping the condition in check and preventing any of these serious health consequences from occurring.
The exact combination of the drugs and diet change will be personally recommended based on the individual medical history and severity of the condition.
The first line therapy for type 2 diabetes is the prescription drug called metformin.
Second line treatment options are given when metformin alone is not effective, or due to other factors that put diabetic patients at risk for developing other health consequences.
One of the most commonly prescribed second line treatment prescription drugs for type 2 diabetes is Jardiance, or empagliflozin.
Jardiance is prescribed in combination with diet and exercise for the treatment of type 2 diabetes.
Jardiance is most often prescribed to diabetic patients to lower their risk of death due to an adverse cardiovascular event such as a heart attack, stroke, or heart failure.
The medication can reduce the risk of a cardiovascular event by 38 percent.
History of Jardiance
Jardiance first gained FDA-approval for the treatment of type 2 diabetes in 2014. It was developed and marketed by a joint venture between two pharmaceutical leaders in diabetes drugs, Eli Lilly and Boehringer Ingelheim Pharmaceuticals.
Eli Lilly is known for the development of the first synthetic human insulin that radically changed the way that diabetes could be treated. Prior to the availability of commercial synthetic insulin, diabetes often lead to fatality due to lack of treatment options.
Boehringer Ingelheim was already one of the leading 20 pharmaceutical companies in the world. In 2011, when Eli Lilly and Boehringer Ingelheim Pharmaceuticals came together in a joint effort to find new therapeutic agents for more effective diabetes treatment, this combined venture resulted in the development of Jardiance.
The companies first filed for approval of the new drug in 2013 and since then, it has been tested through a total of seven clinical trials to assess its efficacy and safety in treating patients with diabetes.
Four of these clinical trials were conducted in the post marketing phase meaning that they occurred after Jardiance was already on the market.
In 2015, a landmark clinical trial named the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA REG OUTCOME) demonstrated a significant reduction in death due to cardiovascular causes in adult patients with type 2 diabetes.
This marked feature made it unique compared to other existing diabetes drugs on the market, and in 2016 the FDA approved Jardiance to reduce cardiovascular death in patients with type 2 diabetes. Jardiance is approved as both a standalone therapy or in combination with other drugs like metformin.
Additional clinical trials studied the performance and safety of the drug in pediatric patients in which the effect of the drug on bone development, renal development and growth were monitored.
Importantly, Jardiance is not FDA-approved for the treatment of type 1 diabetes. Clinical trials showed that unlike its use in type 2 diabetes, Jardiance can induce a dangerous complication called diabetic ketoacidosis in patients with type 1 diabetes.
How does Jardiance work?
Jardiance belongs to the class of drugs called SGL-2 (sodium glucose co-transporter 2) inhibitors. The kidneys play an important role in maintaining normal blood sugar cycling.
When blood sugar levels are abnormally high, as seen in hyperglycemia of diabetic patients, the kidneys reabsorb the excess glucose back into the blood. The SGL-2 transporters are responsible for almost 90 percent of reabsorption of glucose into the blood.
Therefore, blocking their action prevents cycling of excess glucose back into the blood and allows it to be excreted through urine instead.
SGL-2 transporters are also mostly located on renal tubules of the kidneys making the action of Jardiance highly specific for this purpose. SGL-2 inhibitors are chosen for treatment when cardiovascular disease is also present with diabetes.
Jardiance is prescribed more often than other SGL-2 inhibitors.
There is also evidence that Jardiance can help with lowering blood pressure and weight loss in diabetic patients.
These two features make it a popular choice for patients in which this is a priority. Since weight gain and obesity are also medical issues not uncommonly experienced by diabetic patients, the ability of Jardiance to help with weight loss makes this drug stand out compared to other diabetic drugs.
How to take Jardiance
Jardiance is available as 10 mg or 25 mg tablets. Jardiance can be taken alone or most commonly in combination with metformin, sulfonylureas, pioglitazone, or insulin. Jardiance should be taken exactly as prescribed by your doctor.
If it is combined with other medications that lower blood sugar, it can lead to low blood sugar (hypoglycemia). However, when taken alone, Jardiance does not usually cause hypoglycemia.
Jardiance should not be taken by individuals with the following conditions:
- Type 1 diabetes
- Severe renal impairment due to end-stage kidney or renal disease or patients who are on dialysis
- People who have increased ketones in their urine or blood due to diabetic ketoacidosis
- Allergic reaction to Jardiance or SGL-2 inhibitors
The most common side effects associated with taking Jardiance are urinary tract infections, fungal genital infections, and low blood pressure especially in older patients who take diuretics and dehydration.
How can I buy Jardiance?
If you are diagnosed with type 2 diabetes, you will be given a treatment regimen that consists of diet changes, regular exercise, and most likely a combination of prescription drugs that can treat the condition.
These drugs will work to keep blood sugar levels at a normal level. If you are prescribed Jardiance, your doctor will give you a prescription that can be taken into your preferred pharmacy to purchase the medication.
Jardiance cannot be purchased without a valid prescription. The dose that you take is recommended to you based on your personal medical history and the severity of your disease.
Always report other medications that you are taking to your doctor or pharmacist to reduce the occurrence of a severe adverse drug interaction from occurring.
The cost of purchasing Jardiance is on average higher compared to other diabetes medications such as metformin. If you are prescribed Jardiance, it will be because you need the additional benefits that the medication can provide.
References and Sources:
https://pubmed.ncbi.nlm.nih.gov/26378978/
https://en.wikipedia.org/wiki/Diabetes
Fact Checked and Editorial Process
Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Erik Rivera and medically reviewed by Dr. Angel Rivera.
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