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Relationship between Telmisartan Dose and Glycaemic Control in Japanese Patients with Type 2 Diabetes Mellitus and Hypertension

A Retrospective Study

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Abstract

Background and Objectives: Telmisartan has been reported to have beneficial effects on insulin resistance and lipid profiles by acting as a peroxisome proliferator-activated receptor-γ (PPARγ) agonist. In this study we investigated the relationship between telmisartan dose and glycaemic control in Japanese subjects with type 2 diabetes mellitus and hypertension.

Methods: Patients (n = 263) who were prescribed telmisartan 20, 40 or 80 mg/day at our clinic were retrospectively identified from our clinical database. Only patients without changes in their treatments for diabetes and hypertension for 6 months after starting telmisartan were included in this study. Glycosylated haemoglobin A1c (HbA1c) levels were measured at 0, 3 and 6 months after starting telmisartan.

Results: At 3 and 6 months after starting telmisartan, HbA1c levels were significantly decreased in patients treated with telmisartan 40 or 80 mg/day but not in patients treated with telmisartan 20 mg/day (mean ± standard error change at 6 months: −0.29 ± 0.10%, p<0.001; −0.48 ± 0.15%, p<0.001; and −0.03 ± 0.10%, p = 0.33; respectively). When patients were classified into two groups by telmisartan dose (20 vs ≥40 mg/day), there was no significant correlation between baseline HbA1c and change in HbA1c levels over time in the 20 mg/day group. However, in patients treated with ≥40 mg/day of telmisartan, baseline HbA1c was negatively correlated with the change in HbA1c at 6 months. Multiple regression analysis confirmed that baseline HbA1c and telmisartan dose were the predictive factors.

Conclusion: Our results suggest that telmisartan influences glycaemic control in a dose-dependent manner; doses ≥40 mg/day may be needed to improve glycaemic control. Our data also suggest that patients with higher baseline HbA1c may experience greater improvements in glycaemic control with telmisartan.

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Acknowledgements

Kitano Hospital received research grants from MSD, Roche, Novo Nordisk Pharma and Astellas Pharma. Y.H. designed the study, analysed and interpreted the data, and drafted the manuscript. S.H., Y.K., H.I., K.M., Y.I., K.N. and Y.W. contributed to the conduct of the study and to accumulation of the data. K.F. and H.T. helped to draft the manuscript. H.K. critically revised the manuscript for important intellectual content. None of the authors report any conflicts of interest that are directly relevant to this study.

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Authors and Affiliations

  1. Center for Diabetes and Endocrinology, The Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital, Osaka, Japan

    Yoshiyuki Hamamoto, Sachiko Honjo, Yukiko Kawasaki, Hiroki Ikeda, Kanako Mori, Kanta Fujimoto, Hisato Tatsuoka, Yorihiro Iwasaki, Kazuhiro Nomura, Yoshiharu Wada & Hiroki Koshiyama

  2. Ikeda Hospital, Hyogo, Japan

    Hiroki Ikeda

  3. Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Hiroki Koshiyama

Authors
  1. Yoshiyuki Hamamoto
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  2. Sachiko Honjo
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  3. Yukiko Kawasaki
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  4. Hiroki Ikeda
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  5. Kanako Mori
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  6. Kanta Fujimoto
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  7. Hisato Tatsuoka
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  8. Yorihiro Iwasaki
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  9. Kazuhiro Nomura
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  10. Yoshiharu Wada
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  11. Hiroki Koshiyama
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Correspondence to Yoshiyuki Hamamoto.

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Hamamoto, Y., Honjo, S., Kawasaki, Y. et al. Relationship between Telmisartan Dose and Glycaemic Control in Japanese Patients with Type 2 Diabetes Mellitus and Hypertension. Clin Drug Investig 32, 577–582 (2012). https://doi.org/10.1007/BF03261912

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  • DOI: https://doi.org/10.1007/BF03261912

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