Jardiance is not insulin. Jardiance (empagliflozin) is an oral SGLT2 inhibitor — a once-daily tablet that lowers blood sugar by causing the kidneys to excrete excess glucose in urine. Insulin is a hormone given by injection that lowers blood sugar by moving glucose into cells. The two medications belong to entirely different drug classes, work by different mechanisms, and have different side effects. They are sometimes used together but are not interchangeable.
Jardiance vs Insulin at a Glance
| Feature | Jardiance (Empagliflozin) | Insulin |
|---|---|---|
| Drug class | SGLT2 inhibitor | Hormone (peptide) |
| How it is given | Oral tablet, once daily | Subcutaneous injection or pump |
| Mechanism | Blocks kidney glucose reabsorption | Drives glucose into cells |
| A1C reduction | 0.7 to 1.0 percent | Unlimited with dose titration |
| Weight effect | Loss of 2 to 3 kg | Gain of 2 to 5 kg typically |
| Blood pressure | Drops 3 to 5 mmHg | Minimal direct effect |
| Hypoglycemia risk | Low alone; rises with insulin or sulfonylureas | High — main side effect |
| Used in type 1 diabetes? | No (DKA risk) | Yes — essential therapy |
| Cardiovascular benefit | Proven in EMPA-REG OUTCOME | Glycemic only |
| Typical monthly cost (US) | $400 to $570 branded | Variable; biosimilars cheaper |
What Jardiance Actually Is
Jardiance is the brand name for empagliflozin, a member of the sodium-glucose cotransporter 2 (SGLT2) inhibitor class. It was FDA-approved in 2014 for type 2 diabetes and has since picked up indications for heart failure (both reduced and preserved ejection fraction) and chronic kidney disease. It comes as a 10 mg or 25 mg tablet taken once daily, with or without food.
- Active ingredient — empagliflozin
- Drug class — SGLT2 inhibitor (also called gliflozin)
- Route — oral tablet
- Frequency — once daily
- Manufacturer — Boehringer Ingelheim, marketed with Eli Lilly
- Brand variants — Jardiance, Synjardy (with metformin), Glyxambi (with linagliptin), Trijardy XR (with linagliptin and metformin)
What Insulin Is
Insulin is a hormone naturally made by the pancreas. In people who cannot make enough of it — type 1 diabetes, late-stage type 2 diabetes, some pancreas removal cases — synthetic insulin is injected. There are many insulin formulations, classified by how quickly they work and how long they last.
- Rapid-acting — lispro, aspart, glulisine (Humalog, NovoLog, Apidra) — onset 10 to 15 minutes
- Short-acting — regular human insulin (Humulin R, Novolin R)
- Intermediate-acting — NPH (Humulin N, Novolin N)
- Long-acting — glargine, detemir, degludec (Lantus, Levemir, Tresiba) — 24+ hours
- Premixed combinations — for example, 70/30 mixtures
- Route — almost always subcutaneous injection by pen, syringe, or pump; rapid-acting can also be inhaled (Afrezza)
How They Differ Mechanistically
The two drugs lower glucose by mechanisms that share nothing in common.
- Jardiance — works in the kidney’s proximal tubule, blocking the SGLT2 transporter that normally reabsorbs filtered glucose. The result is glucosuria — about 50 to 80 grams of glucose per day excreted in urine. Effect is glucose-dependent (more glucose in blood, more excreted; less glucose, less excreted), which is why hypoglycemia is rare with Jardiance alone.
- Insulin — binds insulin receptors on muscle, liver, and fat cells, triggering glucose uptake from the bloodstream. The effect is not glucose-dependent — too much insulin will drive glucose dangerously low (hypoglycemia), which is the main risk.
What Jardiance Is Approved For
- Type 2 diabetes mellitus — to improve glycemic control as an adjunct to diet and exercise
- Heart failure — to reduce cardiovascular death and heart failure hospitalization in adults with HFrEF or HFpEF, with or without diabetes
- Chronic kidney disease — to reduce kidney disease progression and cardiovascular death in adults with CKD at risk of progression
- Cardiovascular risk reduction — in adults with type 2 diabetes and established cardiovascular disease, based on EMPA-REG OUTCOME data
What Insulin Is Used For
- Type 1 diabetes — required for survival
- Type 2 diabetes — when oral medications and non-insulin injectables cannot maintain target A1C
- Diabetic ketoacidosis and hyperosmolar hyperglycemic state — emergency IV insulin
- Gestational diabetes — when diet and metformin are insufficient
- Post-pancreatectomy or pancreatic dysfunction
- Hospitalized patients with hyperglycemia for inpatient glucose control
Common Jardiance Side Effects
| Side Effect | Approximate Frequency | Severity |
|---|---|---|
| Genital yeast infection | 8 to 12 percent | Usually mild; treatable |
| Urinary tract infection | 5 to 9 percent | Mild to moderate |
| Increased urination | 3 to 4 percent | Usually self-limited |
| Thirst / dehydration | 1 to 2 percent | Mild |
| Dizziness on standing | 1 to 3 percent | Mild; volume-related |
| Euglycemic DKA | Less than 0.1 percent | Serious — urgent care |
| Fournier gangrene | Very rare | Serious — boxed warning |
When Each Is Chosen
- Choose Jardiance when — type 2 diabetes plus cardiovascular disease, heart failure, or CKD; weight loss is a goal; hypoglycemia is a concern
- Choose insulin when — type 1 diabetes; advanced type 2 diabetes; A1C very high at diagnosis (above 10 percent); inability to take oral meds; pregnancy with uncontrolled glucose
- Use both together when — type 2 diabetes still uncontrolled on oral therapy; insulin needed but weight or cardiovascular protection also wanted
Can You Switch Between Them?
Switching depends entirely on your situation. People with type 1 diabetes cannot stop insulin and use Jardiance instead — insulin is non-negotiable for survival. Some people with type 2 diabetes whose pancreas still produces meaningful insulin may be able to add Jardiance and reduce or even stop insulin, especially with weight loss and lifestyle change. This must be done with your clinician monitoring glucose, ketones, and A1C carefully.
Related Reading
For broader treatment context, see our treatment hub, the comparison of empagliflozin vs dapagliflozin, and our explainer on Jardiance for diabetes. For supporting evidence, see the EMPA-REG OUTCOME trial and the ADA Standards of Care 2024.
The Bottom Line
Jardiance is not insulin. It is an oral SGLT2 inhibitor that lowers blood sugar by causing the kidneys to excrete glucose in urine, while insulin is an injected hormone that drives glucose into cells. Jardiance is approved for type 2 diabetes, heart failure, and chronic kidney disease. It typically lowers A1C by 0.7 to 1.0 percent, produces 2 to 3 kg of weight loss, and offers cardiovascular and kidney benefits. Insulin is essential in type 1 diabetes and advanced type 2 diabetes. The two medications are not interchangeable but can be used together when appropriate. Talk to your doctor about which therapy fits your diabetes type, kidney function, and overall risk profile.
