4.6 Effects of Combined Therapy of Empagliflozin and Linagliptin Versus Metformin and Insulin Glargine on Blood Pressure and Vascular Function in Patients with Type 2 Diabetes
Abstract
Abstract Background Combination of insulin with oral antidiabetic drugs is a valid option, but oral combination therapy emerged as an alternative treatment in type 2 diabetes (T2DM). However, the effects on blood pressure (BP) and vascular function of such combination therapies is less clear. Methods In this study 101 patients with T2DM were randomized to receive either empagliflozin 10 mg and linagliptin 5 mg (E+L group) orally or metformin and insulin glargine (M+I group, with dose adjustments according to glucose levels), for 3 months. Patients underwent BP and vascular examination at baseline and after 12 weeks of treatment, including measurement of office and ambulatory BP and vascular function under clinical and ambulatory conditions by validated systems. Results In comparison to baseline, office, 24-hour ambulatory BP and central blood and pulse pressure (PP) values decreased significantly after 12 weeks of treatment with E+L, whereas there was no significant change in vascular parameters in the M+I group (Table 1). Comparing the 2 groups, there were significant decreases in 24-h ambulatory peripheral systolic (mean difference between the 2 groups: −5.2 ± 1.5 mmHg, p = 0.004), diastolic BP (−1.9 ± 1.0 mmHg, p = 0.036) and PP (−3.3 ± 1.0 mmHg, p = 0.007) in favour of E+L. Central systolic BP (−5.56 ± 1.9 mmHg, p = 0.009), forward pressure pulse height (−2.0 ± 0.9 mmHg, p = 0.028) and 24-h ambulatory central systolic (−3.6 ± 1.4 mmHg, p = 0.045), diastolic BP (−1.95 ±…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 101 participants or records.
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