Effects of Liraglutide on Glycemia, Inflammation and Endothelial Function vs Insulin Basal Bolus in Diabetic Inpatients

Effects of Liraglutide on Glycemia, Inflammation and Endothelial Function vs Insulin Basal Bolus in Diabetic Inpatients

Effects of Liraglutide on Glycemic Control, Markers of Inflammation and Endothelial Dysfunction Compared to Scheme Insulin Basal Bolus, in a Population of Diabetic Inpatients and Possible Correlation With Intra-hospital Mortality Rates

The study aims to evaluate the effects of Liraglutide on glycemic control, serum markers of inflammation, markers of endothelial dysfunction and a possible correlation with intra and extra-hospital mortality rates in a group of hospitalized diabetic patients compared to a control group of in-patient diabetic in treatment on insulin Basal-bolus.

135 patients with type 2 diabetes mellitus were recruited at the Internal Medicine with Stroke care ward of the University hospital of Palermo "P. Giaccone" from April 2022 to April 2023. 45 patients were treated with liraglutide, 45 were treated with liraglutide plus Basal Insulin and 45 were undertaken treatment regime with Insulin Basal Bolus (control group). The study was carried out in accordance with the principles of the Helsinki Declaration revised in 2001 and all patients gave their written consent to take part in this research. Each patient treated was compared for age, sex and cardiovascular risk with control patients. The diagnosis of type 2 diabetes mellitus was based on the revised criteria of the American Diabetes Association (ADA), and using a clinical algorithm that considered the age of onset of the disease, the symptoms and weight present, the family history and the therapy practiced. Arterial hypertension was defined according to the 2017 ESC-ESH criteria. Dyslipidemia was defined based on total cholesterol levels> 200 mg/dl, triglycerides> 150 mg/dl and HDL levels <40 mg/dl regardless of the patient's gender. Among the cases enrolled, 135 (100%) had type 2 diabetes mellitus, 110 (80 %) had arterial hypertension and 74 (55%) hypercholesterolemia. Clinical and anthropometric data were collected at the time of recruitment. Blood samples were taken from each patient (cases and controls) to determine serum glucose, HbA1c, CRP, Ferritin, IL-6. These withdrawals were then repeated three months and six months from the time of recruitment. The digital endothelial function was evaluated through the RHI-pat analysis using Endo-PAT2000.

Diabetes therapy with liraglutide and various combinations of glargine insulin, metformin, repaglinide, sulfonylureas.

Diabetes therapy with the combination of a single administration of glargine insulin and three administration of Aspart Insulin.

Change of Endothelial function by the use of Endopat2000 with the evaluation of Reactive Hypereremia Index (normal value of RHI > 1,27)

Inclusion Criteria: Diabetes mellitus type 2 Mild-moderate Hyperglycemia (180-400 mg/dl) Acute events (Pneumonia, Acute cardiac Ischemia, Ictus, IVU) Exclusion Criteria: Diabetes mellitus type 1 Diabetic ketoacidosis Hyperosmolar coma Severe hypoglycaemia Acute Pancreatitis Cancer use of corticosteroids pregnancy Chronic kidney disease (< 30 ml/min) or hemodialysis