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VII. Patient Education and Lifestyle Considerations
For the nearly 36 million Americans living with type 2 diabetes, keeping blood sugar under control is an ongoing challenge. [1] Fortunately, innovative medications like Jardiance provide more options for diabetes patients.
In this article, we’ll discuss everything you need to know about Jardiance: what it is, how it works, side effects, benefits, and dosages.
What is Jardiance?
Jardiance is a once-daily pill that was approved by the FDA in 2014 to assist with four key health concerns:
- Lowering blood sugar in those with type 2 diabetes
- Reducing cardiovascular death risk for people with both diabetes and heart disease
- Lowering hospitalization and death rates for those with heart failure. [2]
- Treating adults with chronic kidney disease [3]
Jardiance belongs to a class of medications known as SGLT2 inhibitors. These drugs take a different approach than other diabetes pills by targeting the kidneys rather than insulin. Jardiance stops the kidneys from putting excess sugar back into the bloodstream after filtration. This lowers overall blood sugar for those with diabetes. [2]
In addition to lowering blood sugar, Jardiance provides cardiovascular benefits by reducing some of the strain on the heart and blood vessels that can come with diabetes. The medication can help reduce the likelihood of cardiovascular death and hospitalization for those also coping with heart disease or heart failure. [2]
How Does Jardiance Work?
Jardiance contains empagliflozin, which belongs to a class of drugs known as SGLT2 inhibitors. SGLT2 proteins are responsible for reabsorbing glucose in the kidneys, returning it from the urine into the bloodstream. In a healthy individual, SGLT2 returns about 90% of filtered glucose to the body. [4]
But in someone with type 2 diabetes, excess glucose in the blood is problematic. This is where Jardiance comes in - it blocks SGLT2 activity, preventing glucose reabsorption. Instead, the extra glucose is excreted through urine, effectively lowering blood sugar levels. [2]
By reducing the amount of glucose in the body, Jardiance helps improve blood sugar control in those with type 2 diabetes. This has a couple of benefits:
- Lowering HbA1c levels, which in turn reduces the risk of complications related to diabetes.
- Encouraging weight loss since the calories in glucose are also excreted from the body. [2]
Indications for Use
When Jardiance was first approved by the FDA in 2014, it was only indicated for treating type 2 diabetes in adults. [2] However, additional FDA-approved uses for this medication have emerged over the years.
- 2016: Jardiance was approved to lower the risk of cardiovascular death in adults with type 2 diabetes. This was an important milestone, as heart disease is a significant complication of diabetes. [5]
- 2022: Jardiance was approved to treat heart failure, a chronic condition where the heart muscle cannot pump enough blood to meet the body's needs. Jardiance can improve heart failure symptoms and reduce hospitalizations by reducing fluid retention and lowering blood pressure. [6]
- 2023: Jardiance was approved for treating chronic kidney disease in adults. [3]
Despite the expanding indications, it is important to note that Jardiance is not suitable for everyone. The medication is not recommended for those with:
- Type 1 diabetes as Jardiance can increase their risk of developing diabetic ketoacidosis.
- Patients with significantly reduced kidney function, such as those with a glomerular filtration rate below 30 mL/min/1.73m2. For most people, the normal GFR is around 90 mL/min/1.73m2. [2]
Benefits of Jardiance
Many benefits of Jardiance make it one of the most effective medications physicians prescribe. All the benefits are supported through various clinical studies.
- Improved glycemic control
- Reduced risk of hospitalization for heart failure and heart-related issues
- Reduced risk of kidney failure
- Improved weight loss [2]
Improved Glycemic Control
Clinical studies show Jardiance's impressive ability to improve glycemic control in adults with type 2 diabetes. After just 24 weeks of treatment, participants taking Jardiance saw promising results:
- Hemoglobin A1c (HbA1C) levels were lowered by 0.7% to 0.8%: HbA1c is a blood test that provides insight into average blood sugar levels over three months. For those with diabetes, controlling HbA1c levels can be challenging. Jardiance helps remove excess glucose through urine, assisting the body in regulating glucose levels. [2]
- Body weight reduced by 2.8% to 3.2%: Some individuals with type 2 diabetes struggle with excess weight, and diet and exercise are typically recommended along with medication. However, even without changes to diet and exercise, Jardiance has been shown to promote weight loss of 2 to 3%. Although Jardiance can contribute to weight loss, it is not approved as a weight loss drug for people without diabetes. [2]
Reduced Risk of Hospitalization and Death from Heart Issues
For those diagnosed with type 2 diabetes, the risk of heart disease and other cardiovascular issues increases significantly. The FDA estimates that people with diabetes have a 70% higher chance of dying from heart disease compared to those without diabetes. [5]
Fortunately, there is good news. Studies show that Jardiance provides important cardiovascular benefits in addition to controlling blood sugar. Specifically, Jardiance has been found to reduce the risk of:
- Cardiovascular death by 38%
- Having a heart attack, stroke, or dying from cardiovascular causes by 14% [7]
Jardiance is currently the only type 2 diabetes medication approved for reducing the risk of cardiovascular death and hospitalization due to heart failure. [2]
Lowers The Risk of Kidney Disease
One of the most concerning complications of type 2 diabetes is kidney disease. About one-third of people with diabetes will develop some level of kidney damage, making diabetes the leading cause of kidney failure in the United States. This is why it's so important for people with type 2 diabetes to take steps to protect their kidney health. [8]
The good news is that studies have found that Jardiance can help lower the risk of kidney disease.
- Jardiance reduces the risk of kidney disease progression by 28%.
- Jardiance reduces the risk of hospitalization due to chronic kidney disease by 14%. [9]
Dosage and Administration
Jardiance comes in tablet form that is taken through the mouth. It’s available in 2 dosages: 10 mg and 25 mg. [2]
When starting Jardiance, your doctor will likely prescribe a low dose of 10 mg once daily to see how your body responds. They may then adjust your dosage over time to find the ideal amount for your needs. The aim is to use the smallest dose that provides the desired benefits. [2]
We’ve included the recommended dosage for different conditions below:
- Reducing the risk of cardiovascular death and hospitalization in patients with heart failure, cardiovascular disease, and type 2 diabetes: Take 10 mg once daily in the morning, with or without food.
- Glycemic control in type 2 diabetes in adults and children: Take 10 mg once daily in the morning, with or without food. If additional blood sugar control is needed, your doctor may increase the dose to 25 mg once daily in patients who tolerate 10 mg. [2]
If you accidentally miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, it is best to skip the missed dose and continue with your regular dosing schedule. Do not double up on the next dose to make up for the missed one. [2]
Safety and Side Effects
When taking any prescription medication, it's important to understand the safety considerations and side effects. Talk to your doctor about any concerns you may have and report any side effects right away. Also, be sure to disclose any other medications or supplements you're taking to avoid unwanted drug interactions.
Side Effects
Jardiance may cause side effects, as with any prescription medication. Knowing the potential side effects is essential so you know what to monitor for and can get medical care immediately if needed.
- Diabetic ketoacidosis: This is a life-threatening condition that requires immediate medical care. Stop taking Jardiance and call your doctor right away if you have symptoms like nausea, vomiting, stomach pain, fatigue, difficulty breathing, or ketones in your urine or blood.
- Dehydration: Jardiance causes the body to lose water and salt, so drink plenty of fluids while taking this medication. Call your doctor if you cannot keep fluids or have symptoms like dizziness, weakness, or excessive thirst.
- Urinary tract infections (UTI): These infections can be severe and may require hospitalization. If you experience a burning sensation during urination, frequent urination, lower abdominal or pelvic pain, or notice blood in your urine, it is important to inform your healthcare provider.
- Hypoglycemia (low blood sugar): If you take Jardiance with insulin or sulfonylurea, your risk of hypoglycemia or low blood sugar increases. Watch for symptoms such as headaches, drowsiness, weakness, dizziness, confusion, hunger, fast heartbeat, sweating, or feeling jittery.
- Allergic reactions: If you are allergic to empagliflozin or any other ingredients in Jardiance, it is important to stop taking the medication and seek immediate medical attention if you develop symptoms such as a rash, raised red areas on your skin, or swelling of your lips, face, mouth, or throat, which can cause difficulty breathing.
- Yeast infection: For females, symptoms may include vaginal odor, abnormal discharge, or itching. For males, symptoms include redness, itching or swelling of the penis, rash, foul-smelling discharge, or pain in the penile area. Your doctor may prescribe an antifungal medication to treat a yeast infection. [10]
Drug Interactions
When you start taking Jardiance, it’s critical to tell your doctor about any other medications you’re on, including other prescription drugs, over-the-counter medications, vitamins, and supplements. This helps avoid unwanted drug interactions.
Some common drug interactions with Jardiance include:
- Diuretics: If you are taking Jardiance along with diuretics, you may experience an increase in urine volume and frequency of urination. This could potentially lead to dehydration. Your doctor will carefully assess your blood volume and renal function before starting you on Jardiance. Additionally, they will monitor you for any signs of decreased blood volume and renal function once you begin taking the medication.
- Insulin or insulin secretagogues: Combining Jardiance with insulin can raise the risk of hypoglycemia (low blood sugar). To minimize this risk, your doctor may need to adjust your insulin dosage while you are taking Jardiance. It's important to follow their guidance and make necessary changes to your insulin regimen.
- Lithium: Jardiance may increase the rate at which the kidneys remove lithium from your body. This can potentially lower the levels of lithium in your system and reduce its effectiveness. If you are taking lithium and starting Jardiance or adjusting your Jardiance dosage, your doctor will monitor your serum lithium concentration more frequently. [2]
Patient Education and Lifestyle Considerations
Diabetes can affect more than just your blood sugar. It's important to be aware of potential complications like
- Nerve damage
- Eye damage
- Heart attack
- Stroke
- Kidney issues [11]
The good news is that medications like Jardiance can help prevent these problems from developing or getting worse. Taking Jardiance exactly as prescribed by your doctor is crucial. Regular follow-up appointments allow your provider to ensure the medication works appropriately to control your blood sugar. If not, they can adjust the dosage or switch you to something more effective. [11]
Lifestyle changes are just as critical as medication in managing diabetes successfully. Making healthy choices helps medication work better as well.
- Physical activity: Exercising just 30 minutes per day can lower blood sugar levels, promote weight loss, reduce stress, and improve fitness. Losing 5 to 10% of excess body weight significantly reduces diabetes risk.
- Nutrition: Nutrition choices directly impact blood sugar levels. Limit simple carbs from foods like sugar, cake, soda, and candy, as these can spike blood glucose.
- Managing stress: Effective stress reduction techniques are vital in diabetes management. Stress can contribute to unhealthy behaviors such as overeating, excessive alcohol consumption, smoking, and inadequate sleep, all of which can exacerbate diabetes.
- Quit smoking: Smokers have a 30 to 40% greater chance of developing diabetes. For those who already have diabetes, smoking increases the risk of complications like nerve damage, kidney disease, heart attack, stroke, and early death. [12]
Conclusion
Jardiance is a promising medication for managing type 2 diabetes and reducing health risks associated with the condition. By blocking excess glucose reabsorption in the kidneys, Jardiance effectively lowers blood sugar levels and provides cardiovascular benefits. For those also coping with heart disease or heart failure, Jardiance can decrease the likelihood of hospitalization and death from heart-related causes. The medication may even slow the progression of chronic kidney disease, a common and serious complication of diabetes.
To learn more about Jardiance, visit our dedicated Jardiance blog. To purchase Jardiance, visit the medication page for up-to-date pricing information.
The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.