Endocrine Abstracts

Hyperinsulinemia that occurs due to insulin resistance play an important role on the development of type 2 diabetes and hypertension. It is shown that apart from their angiotensin II receptor blockage effect, telmisartan and irbesartan can activate intracellular hormone receptor PPARγ. Owing to this dual effect, telmisartan and irbesartan can improve cardiovascular risk factors related to insulin resistance. The aim of this study was to compare the effects of telmisartan and irbesartan on insulin resistance, inflammation, lipid and carbohydrate metabolism of patients with type 2 diabetes and hypertension. Of 53 patients with type 2 diabetes and hypertension were included in the study. Patients were separated into three groups. Only diet and exercise treatment were applied on the first group (n=18), in addition to this treatment, second group (n=18) was administered telmisartan and third group (n=17) was administered irbesartan and they were followed for 6 weeks. Significant decrease was detected in body mass index, average weight, waist/hip ratio, systolic/diastolic blood pressure and insulin resistance in each group at the end of treatment. Serum high sensitive C-reactive protein level significantly decreased in telmisartan and irbesartan group in comparison to pre-treatment period. When compared to the pre-treatment period, significant increase in high-density lipoprotein cholesterol (HDL-C) and significant decrease in fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and glycosylated hemoglobin (A1c) were detected in telmisartan group. Insignificant decreases were detected in total cholesterol, triglyceride, low-density lipoprotein cholesterol, HDL-C, FPG, PPG and A1c in diet-exercise applied control group and in irbesartan group. In conclusion, it was found that there was no difference between the effects of telmisartan and irbesartan treatments on insulin resistance and that they were not statistically superior to the exercise and control group in terms of decreasing insulin resistance.