Metabolic and Lipoprotein Changes in Type 2 Diabetes Patients Treated with Empagliflozin

Background/Objectives: This study evaluated the metabolic effects of empagliflozin, an SGLT2 inhibitor (SGLT2i), in type 2 diabetes patients. Methods: In an observational cohort study, 42 patients received empagliflozin for 1 month, with serum and urine analyzed for IL-6, NT-proBNP, iron metabolism markers, and electrolytes. Another group was treated for 3 months, assessing lipoprotein and glycoprotein profiles, IL-6, and NT-proBNP. Results: Empagliflozin increased serum magnesium (mean difference = 0.26 ± 0.38 mg/dL, p < 0.0001), hemoglobin (mean difference = 0.45 ± 0.78 g/dL, p = 0.0005), and hematocrit (mean difference = 1.74 ± 2.08%, p < 0.0001), while decreasing ferritin (mean difference = −29.23 ± 51.97 ng/mL) and transferrin saturation (mean difference = −3.65 ± 7.22%). NT-proBNP and IL-6 levels trended lower (non-significant). Lipoprotein profiling showed a neutral effect. Conclusions: Empagliflozin positively affected serum magnesium, iron metabolism, and inflammatory markers without altering lipoprotein profiles. Further research is needed to elucidate SGLT2i’s molecular mechanisms underlying their pleiotropic–cardioprotective effects.