HIF1A and Hyperglycemia: In a recent study, the addition of empagliflozin to renal proximal tubule cells exposed to hyperglycemia led to a rise in the expression of the protein HIF-1 (hypoxia-inducible factor-1alpha), a protein responsible for modifying tissue reaction in a hypoxic environment [46] which could offer one of the possible explanations for the protective effect of the drug in question.