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RecruitingNCT05057806Updated Apr 6, 2026

SGLT2 Inhibitors, Ketones, and Cardiovascular Benefit Research Plan

An Early Phase 1 interventional study of Empagliflozin 25 MG and Placebo in Type2 Diabetes and Heart Failure With Preserved Ejection Fraction, sponsored by The University of Texas Health Science Center at San Antonio. Recruiting at 1 site in United States. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-04-06.

Sponsored by The University of Texas Health Science Center at San Antonio · Early Phase 1, Interventional, and Basic science

From the registry’s dates

  • Registered 8 months after the study started (first participant enrolled Jan 2021, registered Sep 2021).
  • Started Jan 2021; still recruiting 5 years 9 months later.
Phase
Early Phase 1
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The study team will examine the effects of SGLT2i (and SGLT2i-induced increases in plasma ketone concentrations) on skeletal muscle and cardiac ketone uptake, skeletal muscle bioenergetics, cardiopulmonary exercise capacity, and patient-reported functional outcomes.

Read the detailed description

The study team will examine effects of elevated plasma ketones caused by 12-week treatment with an SGLT2i (empagliflozin) treatment in participants with T2DM and HF. The study team will focus on three possible mechanisms of action for these effects and test the following:

(i) Skeletal muscle bioenergetics. Using 31P-MRS, the team will quantitate phosphocreatine [PCr], ATP, inorganic phosphate, phosphodiester, and intracellular pH. With 1H-MRS, and will measure intramyocellular lipid content at rest and ATPmax production after exercise. The team will examine the relationships between phosphorous metabolite concentrations, intramyocellular lipid content, and ATP generation before and after 12 weeks of SGLT2 inhibition.

(ii) Cardiopulmonary functional capacity.

(iii) Improvements in Patient-Reported Outcomes (PRO). The Patient-Reported Outcomes Measure Information System (PROMIS) Item Bank v2.0 - Physical Function - Short Form 20a will be used to evaluate self-reported physical function and well-being. This tool is a well-developed and validated method to obtain patient self-reported parameters of health in adults.

02

Conditions studied

  • Type2 Diabetes
  • Heart Failure With Preserved Ejection Fraction

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Keywords

  • Ketones
  • Cardiovascular benefit
03

In context

Ketosis

218 studies on the registry are indexed under Ketosis; 50 are open to participants now.

This study's planned enrollment of 30 is above the median of 20 across 190 interventional studies indexed under Ketosis.

Browse Ketosis studies →

Lead sponsor

The University of Texas Health Science Center at San Antonio is the lead sponsor of 445 studies on the registry; 89 are open to participants now.

Of its 65 completed or terminated interventional studies of FDA-regulated products, 35 (54%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Type 2 Diabetes Mellitus
  • Class II-III (NYHA) heart failure and reduced (EF) \<50%
  • Age 18-80 years
  • 23-38 kg/m2
  • (HbA1c) 5.5-10%
  • Blood Pressure (BP) ≤ 145/85 mmHg
  • Estimated (eGFR) ≥30 ml/min•1.73 m2
  • Stable dose of guideline-directed medications for heart failure and Diabetes
  • Stable body weight (±4 pounds) over the last 3 months
  • Does not suffer from severe claustrophobia
  • No for MRI (metal plates, screws, shrapnel, pins, or cardiac pacemaker)

Exclusion criteria

Exclusion Criteria:

  • Subjects treated with an SGLT2 inhibitor, a glucagon-like peptide-1 receptor agonist (GLP-1 RA) or pioglitazone
  • Pregnancy, lactation or plans to become pregnant
  • Allergy/sensitivity to study drugs or their ingredients
  • Cancer
  • Current drug or alcohol use or dependence
  • Inability or unwillingness of individual or legal guardian/representative to give written
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Early Phase 1
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
30 participants (estimated)

Study arms

  • Experimental
    Empagliflozin Group

    Subjects will be randomized 2:1 to receive empagliflozin, 25mg/day for 3 months

    Drug: Empagliflozin 25 MG

  • Placebo comparator
    Placebo group

    Subjects will be randomized to receive the empagliflozin placebo for 3 months

    Drug: Placebo

Interventions

  • Empagliflozin 25MG will be administered orally once per day for 3 months

    Also known as: Jardiance

  • DrugPlacebo

    The placebo will be administered orally once per day for 3 months

    Also known as: Placebo for Empagliflozin

06

What researchers measure

Primary outcomes

  1. Change in Phosphocreatine

    A measure of phosphocreatine change from baseline to study end

    Time frame: Baseline to 3 months

  2. Change in Adenosine Triphosphate (ATP)

    A measure of ATP change from baseline to study end

    Time frame: Baseline to 3 months

  3. Change in Inorganic Phosphate

    A measure of inorganic phosphate change from baseline to study end

    Time frame: Baseline to 3 months

  4. Change in Phosphodiester

    A measure of phosphodiester change from baseline to study end

    Time frame: Baseline to 3 months

  5. ATPmax production

    Exercise induced ATPmax production change

    Time frame: Baseline to 3 months

Secondary outcomes

  1. Plasma Beta-hydroxybutyrate (β-OH-B)

    Change in β-OH-B

    Time frame: Baseline to 3 months

  2. Acetoacetate concentrations

    Change in acetoacetate concentrations

    Time frame: Baseline to 3 months

  3. Cardiopulmonary Function

    Change in cardiopulmonary functional capacity using oxygen uptake (VO2)

    Time frame: Baseline to 3 months

  4. 6 minute walk test

    Change in the distance that can be covered in a 6 minute walk test

    Time frame: Baseline to 3 months

  5. Patient-Reported Outcomes Measure Information System (PROMIS)

    Change in Physical function will be assessed by the PROMIS Item band v2.0 -Physical Function -Short Form 20a to evaluate patient-reported outcomes of physical function and well being.

    Time frame: Baseline to 3 months

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — The PI will actively participate in journal clubs and symposia and present abstracts at national meetings, as well as submitting manuscripts to top peer-reviewed journals.

Supporting information: Study protocol, Statistical analysis plan

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 6, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05057806
Collaborators
Doris Duke Charitable Foundation, Max and Minnie Tomerlin Voelcker Fund
Responsible party
Sponsor
First posted
Sep 27, 2021
Start date
Jan 13, 2021
Primary completion
Nov 30, 2026 (estimated)
Completion
Mar 31, 2027 (estimated)
Last update
Apr 6, 2026

Study contacts

Carolina Solis-Herrera, MD
Contact
solisherrera@uthscsa.edu
210-567-4900
Francisca M Acosta, PhD
Contact
acostafm@uthscsa.edu
210-450-8677
Carolina Solis-Herrera, MD
principal investigator · The University of Texas Health Science Center at San Antonio

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Empagliflozin

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