Endocrine Abstracts

Atherosclerosis is the major cause of death in type 2 DM. Increased intima media thickness (IMT) denotes subclinical atherosclerosis. Endothelial cells express GLP-1 receptors. There are a few studies regarding the effect of GLP-1 system modifying agents on IMT. Although most of them indicates decreased IMT, the results are contradictory.

We aimed to compare the effect of sitagliptin, vildagliptin, and exenatide on IMT measurement in type 2 DM.

We enrolled 24 patients (7 male, 17 female, aged 53.5±8.2 years, DM duration 4.63±4.46 years, 15 hypertensive, mean initial hemoglobin A1c %7.66±1.43) with type 2 DM. The patients were already using various combinations of oral antidiabetic drugs including metformin, sulphonylurea, or pioglitazone. The data of patients were collected from the records. IMT at baseline and after 6 months of therapy were compared in 6 patients on sitagliptin, 9 on vildagliptin, and 9 on exenatide. Initial and 6^th month data (age, DM age, glucose, hemoglobin A1c, calcium, LDL, HDL, triglyceride, TSH, and IMT) were similar in 3 groups. 3 groups differed significantly in terms of initial and 6^th month BMI (P=0.003 and P=0.001, respectively). When initial and 6^th month data were compared in each group, the difference did not persist.

3 drug groups had similar rates of plaque formation.

Right- and left-side IMT and mean IMT were similar between 3 groups both at baseline and after 6 months of therapy. But when baseline and 6^th month IMT values were evaluated in each group, only right side IMT (lower) differed significantly after 6 months of exenatide therapy (P=0.046).

Although groups are small in size, sitagliptin and vildagliptin has no and exenatide has slight impact on mean IMT in short term of therapy.