This was cohort  study done in which two groups of study populations were selected both groups were diabetics both groups contained pts on OHG drugs as well as those on Insulin . To one group empagliflozin was added along with their baseline medications other group was given placebo. After 4 years  those on OHG drugs  and in EMPA group total 9% of population neede to initiate insulin therapy while jn placebo group 20% of population needed the initiation of insulin . Those who were already on insulin in EMPA GROUP 18% needed to increase their isulin dosage (almost 20% of baseline dosage ) and those in 0lacebo group 35% needed to jncrease their insulin dosage  so this study proved that EMPagliflozin can delay the need to iniyiate insulin or increase dosage of insulin

The main outcomes of EMPA-REG Trials were:

• Improved control of blood glucose
• Reduction in cardiovascular deaths by 38% in patients with T2DM and ASCVD ( atherosclerotic cardiovascular disease)
• Reduction in hospitalization due to heart failure by 35%
• Reduction in all cause mortality by 32%
• an improvement in pre-existing nephropathy was reduced by 39%, and
• a reduction in new-onset macroalbuminuria was reduced by 38%