Medically reviewed by Kacy Church, MD
Last month my endocrinologist asked if I would consider adding Jardiance (empagliflozin) to my diabetes management routine of Glucophage (metformin) twice per day. She explained that it was one available option in a class of diabetes medications known as sodium glucose co-transporter 2 inhibitors (or SGLT2 inhibitors for short). In addition to lowering A1C results, they also may help reduce the risk of death from heart disease in people with type 2 diabetes, according to a review published August 2017 in Current Heart Failure Reports.
She and I were having this conversation after my attempts at altering my dinnertimes, portion sizes, and exercise schedule were not as successful in lowering my elevated fasting blood sugar as we had both hoped. I’m fairly open to trying to new things, and when I heard that Jardiance may improve heart health, I decided to give it try.
Within a week of taking Jardiance, I noticed changes in my blood sugar levels; even sooner, I noticed some of its other effects.
The medication required making some changes in how I manage type 2 diabetes. If you’re considering taking an SGLT2 inhibitor, here’s what you might expect on the basis of my experience, along with some tips on how to deal.
1. Prepare for Frequent Urination
In a matter of hours, I had the urgent need to pee more frequently. Although my endocrinologist described Jardiance as a “mediation designed to make you urinate excess sugar,” I didn’t know it would take effect so quickly. I popped one pill in the morning with breakfast and felt the urge by lunch. I’m not sure how often I emptied my bladder before taking Jardiance, but it certainly wasn’t every two hours, which is my new norm.
I started keeping a tally to share with my endocrinologist at my next visit to see if this is normal. As an educator, I don’t have the luxury of stepping away from my class whenever the urge hits me, so this is a learning curve that I am still adjusting to after a month. I would recommend starting Jardiance on the weekend to give yourself a couple of days to adjust.
2. Know That You’ll Need to Drink More Water
Taking a medication that causes increased urination means you need to be more conscious about drinking fluids. Although it’s been trendy to carry a water bottle around for years, it’s something that I never did. But thanks to the shift in releasing liquids more often, I’ve started carrying a sparkling, rhinestone-covered purple infuser water bottle to work daily. I even upgraded my lunch bag to one that has a slot on the side for a water bottle so I don’t forget it. Having water available at all times helps ensure that I get enough water throughout the day. I’m even thinking about adding a water logging app to my phone because it’s so important to avoid dehydration.
The top side effects of Jardiance are dehydration, urinary tract infections (UTIs), yeast infections, and diabetic ketoacidosis, which is a life-threatening condition. Fortunately, I’ve only experienced leg cramps from slight dehydration during the first week. I probably should have prepped my body before starting the medication by increasing fluids, and I might have avoided having them. When I discussed the side effects with my endocrinologist, she advised me to stop taking the medication if I developed another side effect from the list of possibilities. It helped to know that I don’t have to wait three months for my usual appointment if an emergency happens.
3. Learn How to Log Your Health Information
During this past month, I’ve been reminded that diabetes management requires a lot of mental energy and that simple changes, such as a change in medication, can have a major impact on my daily routine. For example, taking metformin twice a day had become a habit that required little thought. But now I’m counting visits to the restroom, recording how much water I drink, keeping water near, and paying closer attention to any physical changes that I may experience in addition to the usual carb counting, food logging, and finger-pricking for blood sugar testing. Basically, I’m thinking about diabetes a lot more — and that’s a side effect worth mentioning because diabetes management can be overwhelming anyway, and the addition mental work could be exhausting for some people.
Why I’m Happy About My Choice to Take an SGLT2 Inhibitor Despite These Changes
Although the additional medication has brought these changes in my daily routine, I am enjoying seeing the positive results. The best result has been seeing my fasting blood sugar drop within range after a couple of weeks.
The bonuses are losing two pounds in a month, which has brought me closer to my goal weight, attaining clearer skin, which I attribute to drinking more water, and feeling good about knowing that I am taking steps to have a healthy heart. I will see my endo in two months, at which point we’ll discuss how the medication is working for me, but for now, as long as I avoid the negative side effects, I will continue sticking with my new regimen until it becomes second nature.