Anti-Diabetic Effect of Telmisartan Through its Partial PPARγ-Agonistic Activity

Figures & data

Table 1 Effects of Telmisartan in Diabetes Mellitus and Associated Complications

Reference	Study Design	Model	Method and Intervention	Major Outcome(s)
^Citation81	Experimental study	Streptozotocin (STZ)-induced DM in Wistar rats	DM was induced by the administration of STZ. Animals were administered with telmisartan for 28 days	Capillary blood glucose level was lower at all intervals Telmisartan improved the lipid profile. Hypoglycemic activity and improved lipid profile were comparable with glibenclamide
^Citation82	Experimental study	STZ-induced DM in rats	Diabetic rats were treated with/without telmisartan for 2 weeks	Telmisartan decreased SGLT2 expression in the PCT Insulin resistance was ameliorated in diabetic rats
[^Citation83	Experimental study	STZ-induced DM in rats	Diabetic rats were challenged with nicotinamide to induce diabetic nephropathy	The addition of telmisartan to vildagliptin demonstrated the best control over blood pressure, glycemia, and diabetic nephropathy markers, renal structural changes, and improvement of renal function
^Citation84	Experimental study	STZ-induced diabetic nephropathy in rats	After grouping, rats were treated with telmisartan (10 mg/kg), ramipril (5 mg/kg), or vehicle for 16 weeks	Telmisartan pretreatment reduced blood glucose level after 8 weeks Telmisartan significantly altered other parameters towards normal levels
^Citation85	Experimental study	HFFD + STZ-induced diabetes and insulin resistant	Animals were treated with telmisartan and/or metformin	Addition of telmisartan to metformin successfully restored serum glucose back to normal levels and improved serum total cholesterol (TC), triglycerides (TG), and adiponectin
^Citation86	Experimental study	STZ-induced DM	Diabetic rats were treated with telmisartan or gliclazide	Telmisartan or gliclazide produced beneficial effects on serum glucose, Hb, and HbA1c. Restored tissue GSH and SOD with a fall in tissue thiobarbituric acid reactive substances
^Citation87	Clinical study	Five-year, double-blind, double-dummy, randomized study	250 patients with hypertension and early type 2 diabetic nephropathy were included to compare the effect of telmisartan with enalapril	Telmisartan was not inferior to enalapril in reducing the decline in GFR None of the patients developed serum creatinine >200 µmol/L, and none of them required dialysis
^Citation88	Clinical study	Randomized controlled trial	3488 adults at high risk for CVD, but free from diabetes, were involved	21.8% of participants treated with telmisartan and 22.4% of those on placebo developed diabetes Participants originally diagnosed with IFG and/or IGT were equally likely to regress to normoglycemia (26.9% vs 24.5%)
^Citation89	Clinical study	Homeostatic model assessment–insulin resistance (HOMA-IR) in hypertensive subjects with MS	42 patients were involved in the study. Cytokines and metabolic parameters were analyzed before and after treatment with telmisartan	Treatment with telmisartan diminished 35% of HOMA-IR Telmisartan had more favorable effects on glucose homeostasis in patients with MS and low levels of serum cytokines
^Citation90	Clinical study	Randomized, parallel-group, open-label, crossover, prospective study	Patients were on 20 mg of lisinopril or 80 mg of telmisartan once a day for 24 weeks. Then, patients were randomized to continuing treatment with the respective monotherapy or with lisinopril plus telmisartan for a further 28 weeks	Dual blockade may provide a new approach to prevention of diabetic nephropathy in patients with type 2 diabetes, hypertension, and microalbuminuria
^Citation91	Clinical study	Randomized, placebo- controlled, double-blind, crossover study	20 volunteers with insulin resistance and abdominal overweight were involved	Compared to placebo, telmisartan resulted in a reduction in glucose area under the curve during intravenous glucose tolerance There was an increase in the insulinogenic index, indicating improved beta-cell function
^Citation92	Clinical study	Non-comparative, open-label study	34 patients with diabetic nephropathy were involved. Telmisartan (40 mg) was added to ACEI treatment and the patients were observed for 12 weeks	The addition of telmisartan resulted in a significant reduction in albuminuria
^Citation93	Clinical study	Randomized, placebo-controlled, double-blind, multicenter study	Patients with type 2 diabetes and incipient nephropathy were involved. Normotensive type 2 diabetic patients treated with telmisartan or placebo over 52 weeks	Patients treated with telmisartan showed lower transition rates from microalbuminuria to overt nephropathy In addition, more patients on telmisartan reverted to normoalbuminuria. Telmisartan prevented the progression of microalbuminuria in normotensive patients with type 2 diabetes
^Citation94	Clinical study	Randomized controlled comparative trial	82 individuals with DM and HTN were involved. They were on telmisartan or lisinopril or placebo control for 1 month	Significant improvement in both serum malondialdehyde (MDA) and total antioxidants status (TAS) parameters. Both lisinopril and telmisartan were able to subside oxidative stress in diabetic hypertensive patients
^Citation95	Clinical study	Double-blind, parallel-group, randomized study	Patients were treated with once-daily doses of telmisartan or losartan for 3 months	Telmisartan significantly reduced free plasma glucose, free plasma insulin, HOMA-IR, and HbA1c. Plasma glucose and insulin were reduced during the oral glucose tolerance test by telmisartan
^Citation96	Clinical trial	Double-blind, parallel-group, randomized study	65 overweight and obese patients with mild to moderate hypertension were involved. Patients were randomized to telmisartan or olmesartan for 3 months	Telmisartan improved blood pressure, glucose, insulin, HOMA-IR, and leptin in hypertensive diabetic patients

Abbreviations: ACEI, angiotensin-converting enzyme inhibitor; CVD, cardiovascular disease; DM, diabetes mellitus; GFR, glomerular filtration rate; GSH, glutathione; Hb, hemoglobin; HbA_1c, hemoglobin A_1c; HFFD, high-fat, high-fructose diet; HOMA-IR, homeostatic model assessment–insulin resistance; HTN, hypertension; IFG, impaired fasting glucose; IGT, impaired glucose tolerance; MS, metabolic syndrome; PCT, proximal convoluted tubule; SGLT2, sodium–glucose co-transporter-2; SOD, superoxide dismutase; STZ, streptozotocin; TC, total cholesterol; TG, triglyceride.

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