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Endocrine Abstracts (2024) 99 P464 | DOI: 10.1530/endoabs.99.P464

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.

Volume 99

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

European Society of Endocrinology 

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