Hypoglycemic therapy in patients with type 2 diabetes mellitus after cardiovascular surgery

Aziza Tavakkalova; Malika Oblokulova; Kamoliddin Vakkosov; Zulaykho Shamansurova; D.T. Kayumova; M.Sh. Yusupova; Mohammed Abdul Saheeb; Farangiz Ibragimova

doi:10.1530/endoabs.109.P28

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Endocrine Abstracts (2025) 109 P28 | DOI: 10.1530/endoabs.109.P28

SFEBES2025 Poster Presentations Adrenal and Cardiovascular (61 abstracts)

Hypoglycemic therapy in patients with type 2 diabetes mellitus after cardiovascular surgery

Aziza Tavakkalova ¹ , Malika Oblokulova ¹ , Kamoliddin Vakkosov ² , Zulaykho Shamansurova ³ , D.T. Kayumova ⁴ , M.Sh. Yusupova ⁴ , Abdul Saheeb Mohammed ⁵ & Farangiz Ibragimova ¹

Author affiliations

¹Central Asian University, School of Medicine, Tashkent, Uzbekistan; ²American Hospital in Tashkent, Tashkent, Uzbekistan; ³Institute of Biophysics and Biochemistry at the National University of Uzbekistan, Tashkent, Uzbekistan; ⁴Republican Specialised Scientific Practical Medical Centre of Endocrinology, Tashkent, Uzbekistan; ⁵Kimyo International University In Tashkent (KIUT), Tashkent, Uzbekistan

Introduction: The prevalence of type 2 diabetes mellitus (T2DM) is rising, currently affecting over 9% of the adult population. Approximately 52% of these individuals suffer mortality due to cardiovascular disease, highlighting the need for effective surgical management strategies for high-risk patients. This study examines hypoglycemic therapy in T2DM patients undergoing cardiovascular surgery via percutaneous coronary intervention (PCI).

Materials and Methods: We analyzed data from 29 T2DM patients admitted to the Republican Specialized Scientific Practical Medical Centre of Endocrinology. Pre- and post-surgery metrics included fasting and postprandial glycemia, HbA1c, CRP levels, heart rate, and EchoECG findings. Patients were categorized based on hypoglycemic therapy: 12 received basal-bolus insulin therapy, while 8 were treated with SGLT2 inhibitors, with or without incretins (GLP1/GLP1R analogs or DPP4 inhibitors).

Results: Post-surgery, fasting glycemia decreased by 1.7 times (P < 0.05) and postprandial glycemia by 1.8 times (P < 0.05). HbA1c levels also fell significantly (1.4 times, P < 0.05) due to tighter control and adherence to therapy. While heart rates remained stable, both systolic and diastolic blood pressures showed significant reductions. Coagulation improved, evidenced by a 1.4-fold decrease in fibrinogen (P < 0.05) and a 40% reduction in CRP levels. EchoECG results indicated improvements in heart compartment size and function, with myocardial blood flow increasing by 45%. Patients on a combination of SGLT2 inhibitors and incretins exhibited superior biochemical and hemodynamic outcomes.

Conclusions: T2DM patients undergoing cardiovascular surgery demonstrated enhanced glycemic control, reduced CRP levels, and improved heart function, alongside increased cardiac blood flow. Initial findings suggest that combined therapy with SGLT2 inhibitors and incretins may lead to better outcomes. Further research with larger patient cohorts is warranted.