Endocrine Abstracts

Background: Based on various preclinical studies, it is anticipated that azilsartan, an angiotensin II receptor blocker, will increase insulin sensitivity in addition to its antihypertensive effect. The present study was undertaken to evaluate the effect of azilsartan compared to telmisartan on insulin sensitivity in patients of hypertension coexisted with type 2 diabetes mellitus.

Methods: This study was a prospective, randomized, active controlled, open-label, parallel-group trial conducted in a single tertiary care center. Participants with grade I or II essential hypertension associated with type 2 diabetes were randomized into two groups. One group received oral telmisartan 40 mg/day and other group receive oral azilsartan 40 mg/day for 12 weeks. The primary endpoint of our study was the change in the homeostasis model assessment-insulin resistance (HOMA-IR) and secondary end points were change in the metabolic biomarkers like leptin and adiponectin values from the baseline at the end of the treatment period. We also evaluated its safety and efficacy on blood pressure.

Result: The mean changes in HOMA-IR from the baseline at the end of treatment were 0.32 (−0.61.1.26) in the telmisartan group and 0.15 (−0.64.0.94.52) in the azilsartan group. The mean difference in the changes from the baseline in HOMA-R between the azilsartan and telmisartan groups was 0.3 (−0.87.1.48) which was not statistically significant. There were also no statistically significant changes observed between two groups in metabolic biomarkers like leptin and adiponectin. Reduction in clinic systolic and diastolic blood pressure were observed at the end of 12 weeks treatment in both groups. No serious treatment-emergent adverse events (TEAEs) were observed.

Conclusion: Both telmisartan (40 mg) and azilsartan (40 mg) didn’t show any significant effects on insulin resistance parameters and metabolic markers after 12 weeks administration to patients with grade I or II essential hypertension associated with type 2 diabetes mellitus.