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.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.