Introduction: Patients with type 2 diabetes mellitus (T2DM) exert a higher risk for thrombotic events. Platelet reactivity may be used to assess prothrombotic state in such patients. The aim of this study was to investigate whether the administration of novel antidiabetic agents could influence the platelet reactivity in T2DM patients.
Patients and methods: We enrolled 99 consecutive patients (males=63.3%), 64.92±8.3 years old, receiving metformin for T2DM who did not achieve therapeutic targets. Subjects were assigned to 1:1:1 age and sex matched groups (n=33 per group) to receive an additional antidiabetic agent; dipeptidyl peptidase-4 inhibitor (DPP-4i), sodium/glucose cotransporter-2 inhibitor (SGLT-2i) or glucagon like peptide-1 receptor agonist (GLP1-RA). Platelet reactivity was measured with PFA-100 assay; collagen/epinephrine (CEPI) and collagen/ADP closure time (CADP) were calculated in seconds. Glycosylated hemoglobin (HbA1c) was assessed at baseline and 3 months later.
Results: There was no difference for gender (P=0.10) or age (P=0.27) between the 3 study groups. All groups achieved better glycemic control in terms of HbA1c values between baseline and follow-up (7.78% vs 6.92% for DPP-4i, 7.52% vs 6.73% for SGL-2i and 8.19% vs 6.85% for GLP-1RA, P<0.001 for all). Platelet reactivity did not differ significantly at baseline between study groups (P=0.71 for CEPI and P=0.6 for CADP). Additionally, CEPI (P=0.54) or CADP (P=0.43) did not change significantly at follow-up time in all groups.
Conclusions: These preliminary data provided evidence that treatment intensification with DPP-4i, GLP-1RA, SGLT-2i and GLP-1RA in patients with T2DM receiving metformin does not affect their platelet reactivity. Further enrollment of patients and detailed subgroups analyses will elucidate the topic.
18 - 21 May 2019
European Society of Endocrinology