{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Retnakaran R"],"funding":["Heart &amp; Stroke/Richard Lewar Centre of Excellence in Cardiovascular Research","Temerty Faculty of Medicine, University of Toronto","Banting and Best Diabetes Centre, University of Toronto","Canadian Institutes of Health Research","CIHR"],"pagination":["50"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9998007"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["22(1)"],"pubmed_abstract":["<h4>Objective</h4>Basal insulin glargine has a neutral effect on cardiovascular risk in type 2 diabetes (T2DM). In practice, basal insulin is often paired with a glucagon-like peptide-1 receptor agonist (GLP1-RA) or meal insulin; however, the cardiovascular implications of these combinations have not been fully elucidated. In this context, we sought to evaluate the vascular function effects of adding the GLP1-RA exenatide or meal insulin lispro to basal glargine therapy in early T2DM.<h4>Methods</h4>In this 20-week trial, adults with T2DM of < 7-years duration were randomized to 8-weeks treatment with (i) insulin glargine (Glar), (ii) glargine + thrice-daily lispro (Glar/Lispro), or (iii) glargine + twice-daily exenatide (Glar/Exenatide), followed by 12-weeks washout. At baseline, 8-weeks, and washout, fasting endothelial function was assessed with reactive hyperemia index (RHI) measurement by peripheral arterial tonometry.<h4>Results</h4>At baseline, there were no differences in blood pressure (BP), heart rate (HR) or RHI between participants randomized to Glar (n = 24), Glar/Lispro (n = 24), and Glar/Exenatide (n = 25). At 8-weeks, Glar/Exenatide decreased systolic BP (mean - 8.1 mmHg [95%CI - 13.9 to - 2.4], p = 0.008) and diastolic BP (mean - 5.1 mmHg [- 9.0 to - 1.3], p = 0.012) compared to baseline, with no significant changes in HR or RHI. Notably, baseline-adjusted RHI (mean ± SE) did not differ between the groups at 8-weeks (Glar 2.07 ± 0.10; Glar/Lispro 2.00 ± 0.10; Glar/Exenatide 1.81 ± 0.10; p = 0.19), nor did baseline-adjusted BP or HR. There were no differences between the groups in baseline-adjusted RHI, BP or HR after 12-weeks washout.<h4>Conclusion</h4>Adding either exenatide or lispro to basal insulin therapy does not appear to affect fasting endothelial function in early T2DM.<h4>Trial registration</h4>ClinicalTrials.Gov NCT02194595."],"journal":["Cardiovascular diabetology"],"pubmed_title":["The vascular function effects of adding exenatide or meal insulin to basal insulin therapy in early type 2 diabetes."],"pmcid":["PMC9998007"],"funding_grant_id":["MOP 136938"],"pubmed_authors":["Retnakaran R","Ye C","Emery A","Zinman B","Pu J","Kramer CK"],"additional_accession":[]},"is_claimable":false,"name":"The vascular function effects of adding exenatide or meal insulin to basal insulin therapy in early type 2 diabetes.","description":"<h4>Objective</h4>Basal insulin glargine has a neutral effect on cardiovascular risk in type 2 diabetes (T2DM). In practice, basal insulin is often paired with a glucagon-like peptide-1 receptor agonist (GLP1-RA) or meal insulin; however, the cardiovascular implications of these combinations have not been fully elucidated. In this context, we sought to evaluate the vascular function effects of adding the GLP1-RA exenatide or meal insulin lispro to basal glargine therapy in early T2DM.<h4>Methods</h4>In this 20-week trial, adults with T2DM of < 7-years duration were randomized to 8-weeks treatment with (i) insulin glargine (Glar), (ii) glargine + thrice-daily lispro (Glar/Lispro), or (iii) glargine + twice-daily exenatide (Glar/Exenatide), followed by 12-weeks washout. At baseline, 8-weeks, and washout, fasting endothelial function was assessed with reactive hyperemia index (RHI) measurement by peripheral arterial tonometry.<h4>Results</h4>At baseline, there were no differences in blood pressure (BP), heart rate (HR) or RHI between participants randomized to Glar (n = 24), Glar/Lispro (n = 24), and Glar/Exenatide (n = 25). At 8-weeks, Glar/Exenatide decreased systolic BP (mean - 8.1 mmHg [95%CI - 13.9 to - 2.4], p = 0.008) and diastolic BP (mean - 5.1 mmHg [- 9.0 to - 1.3], p = 0.012) compared to baseline, with no significant changes in HR or RHI. Notably, baseline-adjusted RHI (mean ± SE) did not differ between the groups at 8-weeks (Glar 2.07 ± 0.10; Glar/Lispro 2.00 ± 0.10; Glar/Exenatide 1.81 ± 0.10; p = 0.19), nor did baseline-adjusted BP or HR. There were no differences between the groups in baseline-adjusted RHI, BP or HR after 12-weeks washout.<h4>Conclusion</h4>Adding either exenatide or lispro to basal insulin therapy does not appear to affect fasting endothelial function in early T2DM.<h4>Trial registration</h4>ClinicalTrials.Gov NCT02194595.","dates":{"release":"2023-01-01T00:00:00Z","publication":"2023 Mar","modification":"2025-04-04T03:41:53.842Z","creation":"2025-04-04T03:41:53.842Z"},"accession":"S-EPMC9998007","cross_references":{"pubmed":["36894921"],"doi":["10.1186/s12933-023-01781-z"]}}