ECE2024 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (130 abstracts)
Combined dulaglutide-dapagliflozin treatment improves vascular dysfunction and albuminuria vs DPP4 inhibitors independently of glycaemic control
Emmanouil Korakas 1 , Ignatios Ikonomidis 2 , John Thymis 2 , Aikaterini Kountouri 1 , Loukia Pliouta 1 , Konstantinos Katogiannis 2 , Dimitris Benas 2 , Konstantinos Balampanis 1 , Vasiliki Prentza 1 , Foteini Kousathana 1 , Gavriela Kostelli 2 , George Dimitriadis 3 , Athanasios Raptis 1 & Vaia Lambadiari 1
1Attikon University Hospital, Second Department of Internal Medicine, Chaidari, Greece; 2Attikon University Hospital, Second Cardiology Department, Chaidari, Greece; 3Sector of Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Background: The association between diabetes mellitus and diabetic nephropathy with vascular and endothelial properties is well-established. In this study, we compared the effect of combined treatment with dulaglutide and dapagliflozin versus DPP-4 inhibitors on endothelial glycocalyx, arterial stiffness, myocardial function and albuminuria in patients with type 2 diabetes mellitus and albuminuria.
Methods: A total of 60 patients with type 2 diabetes mellitus and albuminuria were randomized to combined dulaglutide and dapagliflozin treatment (n=30) or DPP-4 inhibitors (DPP-4is, (n=30). We measured at baseline and 4 and 12 months posttreatment: (a) perfused boundary region of the sublingual arterial microvessels (marker of endothelial glycocalyx thickness), (b) pulse wave velocity (PWV) and central systolic blood pressure (cSBP), (c) global left ventricular longitudinal strain (GLS) (d) urine albumin-to-creatinine ratio (UACR).
Results: Twelve months posttreatment, the combination of dulaglutide and dapagliflozin showed a greater improvement in all indices compared to DPP-4is, despite a similar reduction in glycosylated hemoglobin. Specifically, dual therapy showed greater improvements vs DPP-4is in PBR (2.10±0.31 to 1.93±0,23 μm vs 2.11±0.31 to 2.08±0.28 μm, P<0.001), in UACR (326±61 to 142±47 mg/g vs 345±48 to 306±60 mg/g, P<0.01), and in PWV (11.77±2.37 to 10.7±2.29 m/s vs 10.64±2.44 to 10.54±2.84 m/s, P<0.001), while only dual therapy showed improvement in cSBP (130.21±17.23 to 123.36±18.42 mmHg). Regarding GLS, both treatments were effective, but dual therapy showed a significantly higher percentage improvement compared to DPP-4is (18.19% vs 6.01%, respectively).
Conclusions: Twelve-month treatment with dulaglutide and dapagliflozin showed a greater improvement in vascular markers an albuminuria than DPP-4is in patients with type 2 diabetes mellitus and albuminuria. Early initiation of combined therapy as add-on to metformin should be considered in these patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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