The investigators plan to enroll 60 patients from the outpatient clinics or inpatient wards of the Metabolism and Cardiology departments who, within the past three months, have undergone coronary angiography for the treatment of coronary artery disease, are currently using sodium-glucose cotransporter-2 (SGLT-2) inhibitors for glycemic control, and have not received glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy for more than three months. A randomized controlled clinical trial will be conducted, with 20 participants randomly assigned to receive semaglutide (a GLP-1 RA) at 1 mg once weekly for 6 months, another 20 participants to receive semaglutide at 0.5 mg once weekly for 6 months, and the control group (20 participants) to continue with standard treatment for 6 months. The effects after 6 months will be evaluated in terms of endothelial function, glycemic control indicators including glycemic variability assessed via continuous glucose monitoring (CGM), oxidative stress markers, and the incidence of symptomatic hypoglycemia. According to the treatment guidelines for type 2 diabetes, either GLP-1 receptor agonists or SGLT-2 inhibitors should be prioritized in patients with type 2 diabetes and coronary artery disease. Therefore, the medication choices in both the intervention and control groups in this study align with current treatment guidelines.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
add-on current standard treatment which includes SGLT2 inhibitor
add-on current standard treatment which includes SGLT2 inhibitor
Taipei Veterans General Hospital
Taipei, Taiwan
change of Time-in-range (%)
continuous glucose monitor, time-in-range defined as percentage of time in range of 70-180 blood glucose levels. Change of time-in-range means time-in-range at week 24 - time-in-range at baseline.
Time frame: From enrollment to the end of treatment at 24 weeks
change of HbA1c
HbA1c at week 24 - HbA1c at baseline
Time frame: From enrollment to the end of treatment at 24 weeks
change of Flow-Mediated Dilatation (FMD)
Flow-Mediated Dilatation (FMD) at week 24 - Flow-Mediated Dilatation (FMD) at baseline
Time frame: From enrollment to the end of treatment at 24 weeks
change of serum ROS measurements
serum ROS measurements at week 24 - serum ROS measurements at baseline
Time frame: From enrollment to the end of treatment at 24 weeks
change of Peripheral Arterial Tonometry (PAT)
Peripheral Arterial Tonometry (PAT) at week 24 - Peripheral Arterial Tonometry (PAT) at baseline
Time frame: From enrollment to the end of treatment at 24 weeks
Hypoglycemic episodes
the amount of hypoglycemic episodes during the treatment period of 24 weeks. hypoglycemic episodes defined as blood sugar levels less than 50 or with hypoglycemic symptoms.
Time frame: from enrollment to the end of treatment at week 24.
change of fasting glucose
fasting glucose ar week 24 - fasting glucose at baseline
Time frame: From enrollment to the end of treatment at week 24
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