The EMPA-FIT Study

Inclusion Criteria:

• Participants were eligible if they had T2D with an HbA1c between 6.5% and 10.0%,were between 20 and 75 years of age, and had not received any anti-diabeticmedications for at least eight weeks prior to screening.

Exclusion Criteria:

• individuals with a body mass index (BMI) <18.5 kg/m² or ≥40 kg/m², clinicallysignificant hepatic impairment (e.g., hepatic cirrhosis, portal hypertension,chronic active hepatitis), or a history of acute cardiovascular events (e.g.,coronary artery disease, cerebrovascular disease, peripheral arterial disease)within two months prior to enrollment. Participants with CKD (eGFR <60 mL/min/1.73m²) or end-stage renal disease (eGFR <15 mL/min/1.73 m² or on dialysis) were alsoexcluded.

Additional exclusion criteria included uncontrolled hypertension (BP ≥160/100 mmHg), New York Heart Association (NYHA) class III or IV heart failure, chronic oral corticosteroid use (>30 consecutive days), a history of cancer (except basal cell carcinoma) within the past five years, or significant dyslipidemia (triglycerides >1,000 mg/dL or LDL cholesterol >250 mg/dL).