A patient with type 2 diabetes and heart failure with preserved ejection fraction (HFpEF) has poor glycemic control on metformin. Which antidiabetic drug has shown benefit specifically in HFpEM and is recommended in this setting?

• A Pioglitazone
• B Glimepiride
• C Sitagliptin
• D Empagliflozin ✓

Explanation

Empagliflozin is approved for heart failure regardless of diabetes status and ejection fraction. The EMPEROR-Preserved trial demonstrated benefit in HFpEF. Pioglitazone (A) is contraindicated in heart failure due to fluid retention. Sitagliptin (C) is neutral in heart failure outcomes. Saxagliptin increases heart failure hospitalizations. Glimepiride (B) offers no cardiovascular benefit.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.