Effects of valsartan compared with telmisartan in reducing insulin resistance on type 2 diabetes mellitus (T2DM) patients with hypertension

Abstract

Insulin resistance is a major risk factor for patients with type 2 diabetes mellitus (T2DM). Telmisartan and valsartan are angiotensin II type I receptor blockers (ARBs) that are often used in patients with metabolic syndrome and T2DM. This study aimed to compare the effect of valsartan and telmisartan in reducing insulin resistance on T2DM with hypertension. Patients of T2DM were open-label screened at the Endocrinology Policlinic, Department of Internal Medicine, Dr. Sardjito General Hospital, Yogyakarta, and then randomized into two groups. The first group received valsartan 80 mg per day up to 160 mg per day, the second group received telmisartan 40 mg per day up to 80 mg per day in addition with life-style modifying and diabetes therapy. Homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride and HDL cholesterol levels of patients were measured before and after receiving telmisartan and valsartan for 12 weeks. A total of forty-nine outpatients were involved in this study comprised of 25 female patients (51%) and 24 male patients (49%) with 27 patients (55.1%) received telmisartan and 22 patients (44.9%) received valsartan as the hypertension therapy. No significantl difference were observed between telmisartan group compared with valsartan group in HOMA-IR (14.01 ± 16.39 vs. 5.31 ± 3.51; p=0.053), triglyceride levels (165.71 ± 94.70 vs 144.41 ± 48.33 mg/dL; p=0.620), HDL-C level (48.57 ± 9.78 vs 49.24 vs 49.24 ± 12.56 mg/dL; p=0.999). In conclusion, telmisartan demonstrated no difference compared to valsartan in reducing insulin resistance on T2DM patients with hypertension.