OBJECTIVES: Insulin use is associated with an increased risk of hypoglycemia, weight gain, cardiovascular disease (CVD), and specific cancers. In EMPA-REG OUTCOME^®, participants with type 2 diabetes (T2D) and CVD, empagliflozin (a sodium–glucose cotransporter 2 inhibitor [SGLT2i]) markedly and durably delayed the need for insulin initiation and reduced the need for large dose increases in patients already using insulin. This study aimed to determine the change in dispensed insulin dose after SGLT2i initiation on top of an insulin-containing regimen in T2DM patients, using a Dutch retrospective prescription database.

METHODS: Data for this study were extracted from the IQVIA Longitudinal Prescription database in the Netherlands. Patients who newly initiated an SGLT2i on top of an insulin-containing regimen and who had continuous treatment nine months before and after SGLT2i initiation (= index-date) were selected. Average dispensed insulin dose was calculated in every three-month period before and after the index-date.

RESULTS: 762 patients met the eligibility criteria (mean age of 62 years; a mean baseline insulin dose of 140 IU/day). The mean (± standard deviation) dispensed insulin dose were 107.4 (±58.5) IU/day, 128.2 (±74.0) IU/day and 183.9 (±106.9) IU/day 9-6 months before, 6-3 months before and 3-0 month before SGLT2i initiation, respectively. The mean dispensed insulin doses were 126.6 (±77.3) IU/day and 113.0 (±64.7) IU/day 3-6 months and 6-9 months after SGLT2i initiation.

CONCLUSIONS: This observational study examined the change of insulin dose after SGLT2i initiation in T2DM patients using real-world data. A considerable decrease in the dispensed insulin dose was observed 3-6 months after SGLT2i initiation. The results are in line with results gained from randomized controlled trials.