Comparison of Empagliflozin-Linagliptin with Empagliflozin- Metformin Combination Therapy in Assessing Cardiovascular Profile and Anemia in Type 2 Diabetic Patients

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.