Objective: This study aimed to compare the effects of empagliflozin-metformin versus empagliflozin- linagliptin combination therapy on cardiovascular parameters and anemia in patients with type 2 diabetes mellitus (T2DM).

Study Design and setting: An analytical study was conducted over 12 weeks at National Medical Centre Hospital, Karachi.

Methodology: T2DM patients were randomly assigned to either the Empagliflozin 12. 5 mg with Metformin 500mg or Empagliflozin 10mg with Linagliptin 5mg. Clinical assessments were conducted at baseline Week 0, 4, and 12, focusing on C-reactive protein levels, blood pressure, temperature, heart rate, respiratory rate, ECG findings, hemoglobin levels, BMI, and glycated hemoglobin (HbA1c) and cardiac examination was performed in all visits. Descriptive statistics were used to compare outcomes between the groups.

Results: The comparative analysis of empagliflozin–metformin (EM) and empagliflozin–linagliptin (EL) regimens demonstrated notable differences in outcomes. HbA1c decreased significantly in both groups, but the EL group showed a greater reduction by week 12 (p = 0.021, OR = 1.65, 95% CI: 1.05 2.58). BMI declined in both arms, but intergroup difference was not statistically significant (p = 0.078). CRP levels dropped more in the EL group, reaching statistical significance (p = 0.037, OR = 1.43, 95% CI: 1.01–2.11). Cardiovascular parameters, including systolic BP (p = 0.116) and diastolic BP (p = 0.098), remained stable, showing no significant differences. ECG (QTc interval) changes were also nonsignificant (p = 0.316). Hemoglobin levels showed no significant difference between groups at week 12 (p = 0.212). Overall, both regimens were effective and cardiovascularly safe, though EL provided superior benefits in glycemic control (HbA1c, p = 0.021) and anti-inflammatory effect (CRP,p = 0.037).

Conclusion: The combination of empagliflozin with either metformin or linagliptin proved to be effective treatment with cardiovascular safety.

Background: Diabetics with coronavirus disease 2019 (COVID-19) manifest more adverse clinical outcomes with elevated rates of death. It has been suggested that the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathway of entrance into the host cell might be assisted bydipeptidyl peptidase-4 (DPP4), leading to inflammation and cytokine storm, with replication into the airways and unfavorable effects in the lungs. Consequently, the goal of this systematic review is to investigate the most recent data on the effect of DPP-4i (dipeptidyl peptidase-4 inhibitor)medications on clinical outcomes, mainly mortality among COVID-19 patients.

Methods: By conducting a systematic search using PubMed and the Cochrane library, observational studies were identified to examine the association between DPP-4i medications and clinical outcomes including mortality, intensive care unit and hospital admissions. The methodologies of included studies were assessed utilizing the Newcastle–Ottawa Scale (NOS).

Results: A total of nineteen studies were included with sample sizes varying from over 100 patients to 2.8 million and variant follow-up durations from 30 days up to discharge or death. Most of thepopulation across the studies had COVID-19 for the first time, and the majority were hospitalized.Similarly, mortality definition varied among studies with different time points consisting of 30-day mortality, in-hospital mortality, or all-cause mortality. The majority of the studies identified no effect on mortality by DPP-4i, while a considerable proportion revealed beneficial effects; only four studies showed increased mortality.

Conclusions: Real-world data from this review suggested a safe use of DPP-4i among COVID-19 patients; however, randomized clinical trials are required to confirm the beneficial outcomes and safe use.

Introdution: Type 2 Diabetes Mellitus (T2DM) and Chronic Kidney Disease (CKD) are highly interconnected, impacting global health. Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i)and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) offer promising benefits for glycemiccontrol, cardiovascular health, and kidney protection. This review compares their effectiveness in enhancing kidney function and glycemic control for T2DM patients with CKD.

Methods: A narrative review was conducted using the PICO framework, searching the PubMed database and online search (ScienceDirect and Google Scholar) for English-language observational research articles published between 2020 and 2025. Articles focused on SGLT2i and GLP-1RA therapies in T2DM patients with CKD, assessing kidney function and glycemic control. Fifteen articles were selected from an initial 706. The keyword use is “comparing” AND “effectiveness” AND “SGLT-2 inhibitor” AND “GLP-1 RA” AND “kidney function” AND “glycemic control” AND “T2DM” AND “CKD” AND “patients”.

Results: SGLT2 inhibitors consistently demonstrated strong renal protective effects, including slower eGFR decline and reduced kidney failure progression. GLP-1RAs excelled in glycemic control, weight management, and cardiovascular event reduction. While SGLT2i generally appeared superior for direct renal protection, some studies suggested comparable renal outcomes. Real-world data largely supported these findings, enhancing clinical applicability.

Conclusion: SGLT2 inhibitors are recommended for T2DM patients with CKD, especially those at higher renal risk. GLP-1RAs are valuable for glycemic control, weight, and cardiovascular benefits. Their complementary mechanisms suggest potential for additive benefits in combination therapy, necessitating further research to optimize patient outcomes.