84 T2DM with microalbuminuria (eUACR) >30 aged 18-75 years irrespective of their A1c, on standard glucose, lipid and BP lowering therapy using telmisartan (Tm) or valsartan (Vs) were followed-up for 2 years. 2 groups were identified, Tm group and Vs group. Renal (Cr, eGFR, UACR) and CV (BP, BMI, Lipid profile, hs-CRP) markers were evaluated at 3-6 month intervals for 2 years. NT-ProBNP was measured at the end of 2 years. Patients with history of major surgery, coronary intervention, IHD or hospitalization in last 1 year, eGFR <45, potassium >5.5 were excluded. Data was analyzed using PSPP version 1.0.1 and represented as Mean (SD) and independent sample t-test and paired t-test was used. P value of 0.05 was considered to be significant.
Results: Baseline therapeutic, renal and CV parameters were well matched in both groups. Mean Tm dose was 86.19mg (SD ± 69.63) and Vs 153.33mg (SD ± 83.77). Within Tm group, mean A1c 1.43% (95% CI 0.95-1.92, p-<0.001), SBP 9.19mm (95% CI 2.58-15.80, p-0.008), TC 38.68mg% (95% CI 26.73-50.63, p-<0.001), LDL 28.35 (95% CI 17.14-39.56, p-<0.001), TG 39.15 (95% CI 20.82-57.47, p-<0.001), Cr 10.66 (95% CI 5.62-15.71, p<0.001), non-HDL 49.42 (95% CI 33.79-65.05, p-<0.001), UACR 87.62 (95% CI 17.03-158.21, p-0.016) reduced significantly. Within Vs group, mean A1c 1.09% (95% CI 0.81-1.38, p-<0.001), TC 24.63mg% (95% CI 15.81-33.46, p-<0.001), LDL 16.67 (95% CI 7.07-26.28, p-0.001), TG 59.26 (95% CI 25.10-53.42, p-<0.001), Cr 15.15 (95% CI 9.28-21.02, p-<0.001), non-HDL 42.57 (95% CI 29.77-55.37, p-<0.001) reduced and HDL 5.98 (95% CI 2.81-9.14, p-0.001) increased significantly. At the end of 2 years there was no difference see in any CV or renal parameter between both groups. NT-ProBNP (Tm 149.16 (±153.36) vs. Vs 203.47 (±335.40), p 0.343) remained high in both groups.
Conclusion: Tm is as effective as Vs with respect to control of CV and renal parameters in T2DM patients with microalbuminuria however NT-ProBNP remained elevated in both groups.
V. Gupta: None. V. Teli: None.