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Background: The association between diabetes mellitus and diabetic nephropathy with vascular and endothelial properties is well-established. In this study, we compared the effect of combined treatment with dulaglutide and dapagliflozin versus DPP-4 inhibitors on endothelial glycocalyx, arterial stiffness, myocardial function and albuminuria in patients with type 2 diabetes mellitus and albuminuria.

Methods: A total of 60 patients with type 2 diabetes mellitus and albuminuria were randomized to combined dulaglutide and dapagliflozin treatment (n= 30) or DPP-4 inhibitors (DPP-4is,(n= 30). We measured at baseline and 4 and 12 months posttreatment:(a) perfused boundary region of the sublingual arterial microvessels (marker of endothelial glycocalyx thickness),(b) pulse wave velocity (PWV) and central systolic blood pressure (cSBP),(c) global left ventricular longitudinal strain (GLS)(d) urine albumin-to-creatinine …