A prospective observational open-label study to evaluate the effect of telmisartan on glycosylated hemoglobin and fasting plasma glucose levels in hypertensive patients with impaired fasting glycaemia

Background: In hypertensive patients with impaired fasting glycaemia (IFG), the incidence of Type 2 diabetes mellitus is 20%, which further worsens the situation. Currently, no approved drug is available for the treatment of IFG. Telmisartan has partial agonistic activity at the PPAR? receptor, thereby reducing insulin resistance. Hence, this study was undertaken. Aim and Objectives: Primary objective: To evaluate the effect of telmisartan on glycosylated haemoglobin (HbA1c) and fasting plasma glucose (FPG) levels. Secondary objective: To evaluate the effect of telmisartan on Body Mass Index (BMI). Materials and Methods: In this prospective observational study, 100 newly diagnosed cases of hypertension with IFG were included. Before the treatment with telmisartan, baseline parameters such as Glycosylated haemoglobin (HbA1c), FPG, BMI, and blood pressure (BP) were recorded. Then, follow-up was done at 4, 8, and 12 weeks. BP and FPG were repeated at 4 and 8 weeks, whereas at 12 weeks all the four parameters were repeated. All the study endpoints were analyzed using paired t-test. Results: In this study, telmisartan reduced mean HbA1c from 5.87 ± 0.09 to 5.66 ± 0.17%, FPG levels from 111.49 ± 3.82 to 104.28 ± 4.60 mg/dl, BMI from 24.20 ± 1.84 to 23.80 ± 1.75 kg/m2 and SBP from 148.44 ± 3.64 to 133.43 ± 3.00, DBP from 91.90 ± 2.37 to 82.08 ± 2.45 mm of Hg at the end of 12 weeks of treatment (P < 0.001). There were no serious adverse effects observed during the study period. Conclusion: In this study, telmisartan reduced HbA1c, FPG, BMI, and BP values significantly. Hence, telmisartan is safe and has a significant effect on the reduction of both BP and insulin resistance.