A clinical study conducted in Pisa and published in Diabetes/Metabolism Research and Reviews has shown that combination therapy with two antidiabetic drugs — empagliflozin, an SGLT2 inhibitor, and linagliptin, a DPP-IV inhibitor — not only improves metabolic control in patients with type 2 diabetes, but also modifies the profile of the urinary microbiota, namely the community of microorganisms that inhabit the bladder and urinary tract, helping to prevent the potential onset of infections.
The study is the result of a collaboration between research groups led by Anna Solini, Associate Professor of Internal Medicine at the University of Pisa and Head of the Departmental Section of Internal Medicine with a metabolic focus at the Azienda Ospedaliero-Universitaria Pisana (Aoup), and Emilia Ghelardi, Associate Professor of Microbiology and Clinical Microbiology at the University of Pisa and Director of the Specialisation School in Microbiology and Virology.
The research demonstrated for the first time that dysbiosis of the urinary microbiota — that is, the quantitative and qualitative imbalance detectable in urine reflecting alterations in bacterial flora (with a predominance of “harmful” bacteria over beneficial ones, typical of individuals with type 2 diabetes) — can be worsened by therapy with empagliflozin alone (a drug that is effective in protecting the heart and kidneys). By contrast, the combination of empagliflozin and linagliptin was shown to reduce the presence of pathogenic bacterial species, thereby reducing the potential development of genitourinary infections, with positive effects on adherence to SGLT2-inhibitor therapy and on the long-term management of diabetic complications.
