Empagliflozin may improve nighttime blood sugar patterns in type 1 diabetes
Last updated May 6, 2026
Key finding
In a small 8-week study of adults with type 1 diabetes, empagliflozin lowered HbA1c and appeared to improve nighttime glucose patterns while reducing insulin needs, without increasing time spent in low blood sugar.
This study tested empagliflozin as an add-on to insulin in adults with type 1 diabetes. Over 8 weeks, HbA1c improved, insulin doses fell, and glucose patterns looked better at night than during the day. Time spent in low blood sugar did not clearly increase, but the study was small and did not include a control group.
Quick read
Study at a glance
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EvidenceScore™
Low
Study type
non-randomized clinical trial (non-RCT or NRCT)
Follow-up
Short-Term (≤3 mo)
Risk of bias
High Risk
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Plain-language summary
What this paper says
A plain-language read of the study’s main message and where it applies.
Study focus
In a small 8-week study of adults with type 1 diabetes, empagliflozin lowered HbA1c and appeared to improve nighttime glucose patterns while reducing insulin needs, without increasing time spent in low blood sugar.
Published in
Journal Reference
Publication details and source links for this paper.
Perkins BA, Cherney DZI, Soleymanlou N, et al. Diurnal Glycemic Patterns during an 8-Week Open-Label Proof-of-Concept Trial of Empagliflozin in Type 1 Diabetes. PLoS One. 2015;10(11):e0141085. doi:10.1371/journal.pone.0141085
Main Effects
HbA1c ↓ from 8.03% to 7.62% during treatment
Blood glucose patterns improved more at night than during the day
Total daily insulin dose ↓ by about 17%, mainly from lower basal insulin
Evidence Suggest
- Continuous glucose monitoring showed modest improvement during treatment and worsening after empagliflozin was stopped
- Nighttime glycemic exposure fell more than daytime exposure during treatment
- Time spent in low glucose did not clearly increase during treatment
Who this applies to
This study involved adults with type 1 diabetes who were normotensive and normoalbuminuric, with HbA1c between 6.5% and 11.0%. About two-thirds used insulin pumps and one-third used multiple daily injections. The findings may be most relevant to relatively young adults with uncomplicated type 1 diabetes receiving intensive insulin therapy.
Keep in Mind
This study does not prove that empagliflozin is broadly safe or effective for all people with type 1 diabetes. It was industry funded, open label, and exploratory. The paper also gives limited information here on uncommon but important risks such as ketoacidosis. Any use of this kind of therapy in type 1 diabetes needs careful clinical supervision and individualized insulin adjustment.
Between the Lines
- Single-arm open-label design with no control group
- Small sample size of 40 participants
- Most CGM findings were trends rather than strong between-period effects
- Short treatment and follow-up periods
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