Effect of Linagliptin on Vascular Inflammation in Patients With Type 2 Diabetes Mellitus

Inclusion Criteria: 1. Diabetes mellitus Type 2 2. HbA1c \> 7% 3. Age \> 50 years 4. Coronary artery disease or carotid artery disease 5. 18F-FDG uptake of the carotid arterial wall to background (blood) ratio \> 1.8 6. Written informed consent prior to study participation 7. Stable anti-diabetic and cholesterol lowering medication for the last 3 month 8. Stable anti-diabetic medication for the last 6 weeks which should include a maximal tolerated dose of metformin (unless contraindication or intolerance to metformin does exist); 9. Indication to increase anti-diabetic medication as judged by the investigator Exclusion Criteria: 1. Diabetes mellitus type 1 2. Use of DPP-4 Inhibitor, GLP-1 agonists, Thiazolindinedione 3. Kidney disease CKD 4 and more (GFR \< 30 ml/min/1.73) 4. Liver disease (ALT or AST \> 3 times the upper limit of norm) or known liver cirrhosis 5. Any reason for not being able to sustain the imaging studies 6. Pacemaker/ICD/metallic clips in close relation to vessels in the brain 7. Uncontrolled thyroid disease 8. Active malignant disease 9. Chronic inflammatory disease 10. Chronic use of NSAR or cortison 11. HbA1c \> 8.5% 12. Recent (\<3 months) clinically significant coronary or cerebral vascular event 13. Pregnant females as determined by positive \[serum or urine\] HCG test at Screening or prior to dosing 14. Lactating females 15. The subject has a history of any other illness, which, in the opinion of the Investigator, might pose an unacceptable risk by administering study medication 16. The subject received an investigational drug within 30 days prior to inclusion into this study 17. The subject has any current or past medical condition and/or required medication to treat a condition that could affect the evaluation of the study 18. The subject is unwilling or unable to follow the procedures outlined in the protocol 19. The subject is mentally or legally incapacitated