I’ve been prediabetic for the past 10 years or so (A1c 5.7-5.9). I have never been overweight and my diet and exercise habits have always been very good. Male, 67 yo.
I started out with empagliflozin 12.5mg/day. Also from India, but original manufacturer, not generic. Initially, for several weeks, it seemed to bring my morning BG down to sub-100 mg/dL, into the 90’s and even occasional 80’s. Whereas ordinarily it was always in the 106-112 range in the morning (dawn effect). I used the same glucose monitor. However, after a few weeks, not changing anything else in meds, supps, diet or exercise, the BG drifted back to the original pre-empa readings. I was on this dose for 4 months. I tested myself at LabCorp, and the glucose readings were identical to pre-empa from 5 months ago: FBG of 108 mg/dL and A1c of 5.8%. Interestingly, the two tests were a before and after in the respect of in addition to empagliflozin, I changed from atorvastatin 10mg/day to pitavastatin 4mg/day and added rapamycin Eris/Biocon brand 6mg/1-week for 11 weeks. Yet zero changes in fasting glucose and A1c.
Kidney labs were essentially unchanged (for example serum albumin went from 4.8 to 4.7, creatinine 0.82 to 0.83 etc.). I didn’t do a urine test however. I did use a test strip at home to check that there was glucose in my urine with empa, and there was.
Subjectively I felt nothing different. No weight loss either (BMI of 21.4). No excess thirst.
It’s as if I took nothing.
I then upped the dose to 25mg/day. No change in supps, diet or exercise. However, I added bempedoic acid 180mg/day. And during this time I was coming off a rapamycin break (due to surgery), and then back on rapamycin for three weeks also 6mg/1-week, but Zydus brand. I was on the 25mg/day dose of empagliflozin for 39 days and tested again at LabCorp.
This time the glucose readings were dramatically different. FBG went from the previous 108 to 96, insulin from 14.2 uUI/mL to 8.6. I didn’t test A1c this time because it wasn’t 3 months yet between tests. However, a couple of things must be kept in mind. I was on the 25mg dose for only 39 days - and when I originally went on empa at the 12.5mg/day dose it also dropped my FBG in the first few weeks, but then drifted back up. It’s entirely possible that the same will happen in time with the 25mg dose. And while the kidney numbers were roughly the same, many other labs got substantially worse on bempedoic acid - however it’s likely a one off.
I continue on the 25mg/day dose and will test again early August with the only change being dropping bempedoic acid and going on ezetimibe 10mg/day for 50 days. I will also test A1c at that time.
As previously with the 12.5mg/day dose, I continue to not feel anything different subjectively, no weight change, no thirst etc.
If there is no change to my A1c of 5.8 or FBG above 100, and I continue to be prediabetic, I will add pioglitazone 7.5mg/day and possibly experiment with acarbose.
I take the empa dose first thing in the morning after I get up, hours before I eat, with water or tea.
Bottom line - in 7 months of empagliflozin on 12.5 and 25mg daily doses I have had zero subjective feelings of change, zero side affects, no weight changes, and no lab changes on 12.5mg, possible changes in labs on 25mg, but too early to tell, have to wait for a retest. That’s my n=1 report.
