Beneficial Effects of Telmisartan in Treatment of Hypertension With Type Two Diabetic Patients in Salahaddin Society

Abstract

Background: Diabetes is a chronic illness lead to acute complications that required patient self-management education and life style care to prevent complication This study aims is to determine the degree of 12 weeks telmisartan therapy on the level of systolic blood pressure (SBP) & diastolic blood pressure (DPB), mean arterial pressure (MAP), serum glucose level, glycated hemoglobin(HbAlc) level and microalbuminuria (MA) as a marker of renal deterioration recently diagnosed hypertensive type two diabetes mellitus (T2DM) patients. Patients & Methods: Forty six newly diagnosed hypertensive patients with types 2 diabetes mellitus participated in the study(2017); 22 males and 24 females, their mean age was 52.93± 7.69 years. Eighty one apparently healthy persons (36 male and 45 female), who had no chronic disease and didn't receive any chronic therapy participated in the study as a control group. Both groups were matched regarding age and sex. BP was measured using a mercury sphygmomanometer with the subject waiting for a 5-minutes rest. Fasting serum glucose (FSG) concentration was estimated using a kit supplied by Biocon (Germany). HbAl c is measured in whole blood sample by ion-exchange resin quantitative colorimetric determination using a kit supplied from Stanbio (USA). Microalbuminuria measured by detecting protein-creatinine ratio (PCR) which include determination of urine protein by sulphosalicylic acid 3%, measuring urine creatinine by using a kit supplied from SyrBio company and finally calculation of PCR by dividing protein concentration in urine upon creatinine concentration in urine . Result: Showed that T2DM patients having a significant rise in SBP, DBP and MAP, also persistent hypertension lead to overt diabetic nephropathy, and there is diabetes and hypertension have a close relationship between due to resistance to insulin action on glucose uptake in peripheral tissues as compared with the control group. After a 12 weeks telmisartan monotherapy there was a significant reduction in SBP, DBP, MAP, FSG and microalbuminuria level. Conclusion: Telmisartan has a valuable renal protective effect by decreasing proteinuria, also it have a specific antihyperglycemic effect beyond angiotensin II receptor antagonism in addition to its hypotensive effects