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Additionally, SGLT2i can lower HbA1c levels by 0.5-1.0% and support weight loss ( Studies have indicated that increased expression of the sodium-hydrogen exchanger isoform 1 (NHE-1) is linked to heart failure and may contribute to the development of hypertrophy and cardiac injury during ischemia and reperfusion ( Of note, long-term use of SGLT2i may lead to a reduction in glycosuric efficacy, without a corresponding decline in cardiovascular benefits

The net effect on apixaban clearance is speculative but theoretically could increase apixaban renal clearance slightly in this population

Measurable weight loss often becomes clearer by weeks 4 to 12 as doses increase and eating patterns stabilise