Fewer ECG Abnormalities in Early T2D With Combo Therapy

METHODOLOGY:

Researchers aimed to examine ECG abnormalities and cardiovascular autonomic neuropathy across the different glucose-lowering treatment groups in 5029 participants (mean age, 57.2 years; diabetes duration, 4.2 years; A1c level, 7.5%; 36.4% women) from the GRADE trial.
The participants had T2D for less than 10 years and were initially taking metformin monotherapy before being randomly assigned to receive metformin plus one of four commonly used glucose-lowering agents (insulin glargine, glimepiride, liraglutide, or sitagliptin).
Patients were followed up for an average of 5 years.
Resting ECGs were recorded at baseline and at 2‐ and 4‐year follow-ups and analyzed for overall, major, and minor abnormalities, as well as heart rate variability — a measure of cardiovascular autonomic neuropathy.

More than half of participants in the GRADE trial had ECG abnormalities (57.1%) and ECG-defined cardiovascular autonomic neuropathy (52.8%) at baseline. The presence of these abnormalities was associated with longer diabetes duration, higher systolic blood pressure, greater prevalence of hyperlipidemia, more frequent use of lipid-lowering treatment, and beta-blocker use.
Major ECG abnormalities occurred less frequently in the liraglutide group than in the other treatment groups (9% vs 13% at 4 years).
Researchers found no significant differences in ECG-defined cardiovascular autonomic neuropathy between the liraglutide and non-liraglutide groups at 2 and 4 years (P = .42).

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