This study was designed to evaluate the effect of ARB in improving insulin secretion in patients with type 2 diabetes. The investigators also aimed to evaluate if there are potential synergisms between ARB and DPP4 inhibitors in improving insulin secretion and urinary albumin secretion in diabetic patients.
Angiotensin II has been reported to insulin secretion in beta cells. Angiotensin II indirectly improves insulin secretion in beta cells via vasoconstriction and reduced islet blood flow. Chronic exposure to high glucose or high fat increases expression of AT1R (angiotensin type 1 receptor), leading to reactive oxidative stresses, inflammation, and apoptosis in beta cells, finally decreased insulin formation and secretion. Some studies showed the beneficial effect of blocking AT1R on insulin secretion and beta cell proliferation in animal models using angiotensin receptor blocker (ARB). Furthermore, 26 weeks of valsartan treatment improved insulin secretion in humans with impaired glucose regulation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
46
16 weeks of fimasartan vs. amlodipine followed by 2 weeks of wash-out period, then crossover
16 weeks of fimasartan vs. amlodipine followed by 2 weeks of wash-out period, then crossover
Seoul National University Hospital
Seoul, South Korea
Insulinogenic index
Time frame: 16 week
HOMA β-cell function
Time frame: 16 week
Insulin resistance
Time frame: 16 week
Urinary albumin creatinine ratio, urinary protein creatinine ratio
Time frame: 16 week
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