The impact of various hypoglycemic modalities on endothelium dysfunction biomarkers in patients with T2DM

Abstract

Major contributors to morbidity and mortality in diabetic patients are diabetic vascular complications. The impairment of endothelial function seems to be a constant observation in people with diabetes. The objective of the current study was to investigate the impact of various treatment modalities on the endothelial biomarker in T2DM. This study involved 182 participants, divided into seven groups: 20 healthy subjects as a control, 35 newly diagnosed patients with diabetes without treatment, and 127 patients already on different antidiabetic medications for three months. Levels of cholesterol, triglycerides (TG), low-density lipoprotein (LDL), glycated hemoglobin (HbA1c), random blood sugar (RBS), oxidized nitric oxide (NOx), endoglin (ENG), intercellular adhesion molecule (ICAM-1), and glutathione (GSH) are measured for all participants compared with the healthy control. All the other groups significantly increased their lipid profile, HbA1c, RBS, and blood pressure, with a high significance observed in the untreated group. In contrast, a significant increase in NOx levels in the pioglitazone-treated group and ENG levels seems close to normal control, while a significant elevation of ICAM-1 and reduction in GSH levels. Although SGLT2 therapy caused a significant decrease in cholesterol and LDL, the level of ENG was significantly higher, and the level of GSH was considerably lower than in the other groups. In conclusion, the pioglitazone-treated group had the lowest HbA1c and blood pressure and was equivalent to the normal control group. The pioglitazone-treated group had the greatest amount of NOx, which prevents endothelial dysfunction, whereas the SGLT2 group had the lowest impact on these biomarkers.