Telmisartan versus amlodipine in patients with concurrent type 2 diabetes mellitus and hypertension: Comparing efficacy in terms of insulin resistance and lipid profile
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ABSTRACT
BACKGROUND: To explore the impact of telmisartan versus amlodipine on insulin resistance, this study aims to measure the homeostasis model assessment ratio of insulin resistance (HOMA-IR) and assess other diabetes-related variables, lipid parameters, and adiponectin levels. The study group involves patients presenting with both grade I or II essential hypertension and type 2 diabetes mellitus (T2DM).
MATERIAL AND METHODS: Conducted between November 2005 and March 2006, this prospective cohort study enrolled patients with type 2 diabetes mellitus (T2DM) and newly-diagnosed essential hypertension. The participants received either telmisartan or amlodipine treatment. Various parameters, including height, weight, blood pressure, and laboratory values (fasting blood glucose, HbA1c, insulin, C-peptide, adiponectin, total cholesterol, HDL-C, LDL-C, and triglycerides), were measured at the initial visit and after 12 weeks of antihypertensive treatment. The study focused on calculating insulin resistance using the HOMA-IR.
RESULTS: Nineteen patients on amlodipine and twenty patients on telmisartan participated in the study, with no significant
differences in age (p = 0.326) or sex distribution (p = 1.000). Except for HDL-C, baseline laboratory data were similar. Both amlodipine (p = 0.001) and telmisartan (p<0.001) recipients experienced a significant decrease in BMI after treatment, resulting in comparable BMI values at 12 weeks (p = 0.882). Both treatments significantly reduced systolic and diastolic blood pressure (p<0.001 for both), with no significant difference between the groups. In the telmisartan group, insulin levels significantly increased post-treatment (p = 0.004), while total cholesterol (p = 0.006), HDL-C (p = 0.001), and LDL-C (p = 0.049) levels decreased significantly.
CONCLUSION: Compared to amlodipine therapy, telmisartan created greater improvements in lipid parameters and insulin levels among patients with concurrent KASAV International Journal of Health Sciences. 2024;Volume 6(1) ISSN:2630-6085 15
hypertension and T2DM.