EVALUATION OF OXIDATIVE STRESS AND INFLAMMATORY BIOMARKERS IN DIABETIC PATIENTS TREATED WITH METFORMIN AND EMPAGLIFLOZIN: A CROSS-SECTIONAL STUDY

Type 2 diabetes mellitus (T2DM) is associated with persistent oxidative stress and chronic low-grade inflammation, which accelerate vascular and metabolic complications. Metformin and empagliflozin are widely prescribed oral antidiabetic agents, each with potential pleiotropic benefits beyond glucose lowering. Comparative data on their effects on oxidative and inflammatory biomarkers in South Asian populations remain limited. Objective: To evaluate oxidative stress and inflammatory biomarkers in T2DM patients treated with metformin and empagliflozin compared with healthy controls. Methods: This cross-sectional study was carried out between January 2024 and January 2025 at the Sughra Shafi Medical Complex in Narowal and the Ittefaq Hospital Trust in Lahore. A total of 150 people were enrolled: 50 T2DM patients using metformin, 50 taking empagliflozin, and 50 healthy controls of similar age and gender. Demographic and clinical information was collected. Fasting glucose, HbA1c, and lipid profile were all investigated in the laboratory. Oxidative stress indicators (MDA, SOD, catalase) and inflammatory biomarkers (IL-6, hs-CRP) were also assessed. The data was analyzed using SPSS v26 with one-way ANOVA, and p < 0.05 was considered statistically significant. Results: Diabetic patients exhibited significantly higher MDA, hs-CRP, and IL-6 levels compared with controls (p < 0.001). Empagliflozin-treated patients had significantly lower MDA (3.3 ± 0.5 µmol/L) and IL-6 (5.0 ± 1.3 pg/mL), and higher SOD (123 ± 18 U/mL) and catalase (79 ± 11 U/mL) activity compared with the metformin group (p < 0.05). Glycemic indices, including HbA1c, were comparable between treatment groups. Conclusion: Both metformin and empagliflozin improved oxidative stress and inflammatory profiles in T2DM patients. Empagliflozin demonstrated superior antioxidant and anti-inflammatory effects, suggesting potential benefits in reducing long-term diabetic complications.