Association of Empagliflozin Therapy with Cardiovascular Outcomes, diabetic retinopathy and Otorhinolaryngological complications in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with multisystem complications affecting the cardiovascular system, retina and otorhinolaryngological (ENT) structures. Diabetic retinopathy represented a major cause of preventable visual impairment, whereas ENT manifestations including sensorineural hearing impairment, tinnitus, recurrent otitis externa and sinonasal symptoms. Empagliflozin, a Sodium–Glucose Cotransporter-2 (SGLT2) inhibitor, anti-hyperglycemic drug that demonstrated established cardiovascular and renal benefits. Objective: The study aimed to evaluate the association between empagliflozin therapy in preventing diabetes complications i.e, retinopathy and ENT complications in patients with T2DM, with secondary assessment of glycemic control and cardiovascular outcomes. Methodology: A cross-sectional analytical study was conducted at Abbasi Shaheed hospital among adults diagnosed with T2DM. Participants were categorized according to empagliflozin exposure, including current users and non-users or patients receiving alternative glucose-lowering therapies. Data were collected regarding demographic characteristics, duration of diabetes, glycated hemoglobin (HbA1c), treatment history, comorbidities and cardiovascular risk factors. Retinal outcomes were assessed through documented ophthalmological examinations including diabetic retinopathy severity and the presence of diabetic macular edema. ENT assessment focused on hearing impairment, tinnitus, recurrent otitis externa, sinonasal symptoms and other documented otorhinolaryngological manifestations. Cardiovascular history included ischemic heart disease, heart failure and relevant cardiovascular events. Appropriate comparative and multivariable statistical methods were used with statistical significance established at p<0.05. Results: The prevalence of diabetic retinopathy and individual ENT complications was evaluated and compared between empagliflozin users and the comparison group. Associations with empagliflozin exposure reduces HbA1c levels, prevent diabetic retinopathy and has positive effects in reducing otolaryngological symptoms. Conclusion: The study evaluated the relationship between empagliflozin therapy, diabetic retinopathy and ENT complications in patients with T2DM. The assessment emphasized retinal and otorhinolaryngological manifestations alongside cardiovascular outcomes and highlighted the clinical relevance of multidisciplinary screening. The study showed that empagliflozin had indirect effect on preventing this complication by reducing blood sugar level in body.