Effect of a 12-month treatment with liraglutide, empagliflozin and their combination on carotid intima-media thickness in patients with type 2 diabetes mellitus
Abstract
Type 2 diabetes mellitus (T2DM) is an additional factor for exacerbation of atherosclerosis increasing the risk for coronary artery disease and ischemic stroke. Evaluation of carotid artery atherosclerosis through ultrasound techniques is an important method for risk stratification in patients with T2DM.
We investigated the effect of insulin, glucagon like peptide-1 receptor agonists (GLP-1RA), sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and their combination on carotid intima-media thickness (cIMT) of T2DM patients.
We studied 183 consecutive T2DM patients who were treated with insulin (n=45), liraglutide (GLP-1RA) (n=46), empagliflozin (SGLT-2i) (n=47) or their combination (liraglutide+empagliflozin) (n=45) as add-on to metformin and were matched using propensity score analysis. At baseline, at 6 and 12 months of treatment, we measured the maximal thickness of six major points including right and left common carotid, carotid bifurcation and internal carotids. Finally, we calculated the average cIMT of all six segments to get mean cIMT. In addition, lipid profile and malondialdehyde (MDA), as a marker of oxidative stress, were evaluated in all participants.
Compared to baseline, all patients had significantly reduced cIMT, total cholesterol, low-density lipoprotein cholesterol, triglycerides and MDA at 6 and 12 months of treatment (p1.5mm, which is considered plaque equivalent. Of those, the percentage of patients who reduced cIMT <1.5mm after 12-month treatment was…
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