Title:Endothelial Dysfunction and Platelet Hyperaggregation in Type 2 Diabetes Mellitus: The Era of Novel Anti-diabetic Agents
Volume: 28
Issue: 20
Author(s): Stylianos Daios, Georgia Kaiafa, Dimitrios Pilalas, Ifigeneia Nakou, Ilias Kanellos, Konstantinos Kirdas, Kalliopi Despoudi, Nikolaos Papanas and Christos Savopoulos*
Affiliation:
- First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital of Thessaloniki, Thessaloniki,Greece
Keywords:
Endothelial Dysfunction, Platelet Hyperaggregation, Diabetes Mellitus, GLP-1 receptor agonists, DPP-
4 inhibitors, SGLT-2 inhibitors, antidiabetic medication, Endothelium.
Abstract:
Background: The incidence of diabetes mellitus (DM) is ever-increasing and along
with its microvascular and macrovascular complications, it is associated with a high morbidity
and mortality burden globally. Major components of diabetes pathophysiology include glucotoxicity,
lipotoxicity and insulin resistance, disturbing the vascular wall integrity and leading
to endothelial dysfunction and platelet hyper aggregation.
Objective: This review aims to identify and summarize the effect of novel anti-diabetic agents
(glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, sodium-glucose
co-transporter -2 inhibitors) on endothelial (EF) and platelet function (PF) and evaluate the
consistency with the results of cardiovascular outcomes studies.
Methods: We performed a structured search of the PubMed database for peer-reviewed research
of the literature between 1981 and 2020 regarding the effect of DM and novel antidiabetic
agents on EF and PF.
Results: We analyzed data regarding the effect of novel anti-diabetic agents on EF and PF as
well as the pathophysiological interplay between DM, PF, and EF. The available studies use
different methods to evaluate these outcomes and the results of different studies are rather
conflicting as a result of different study designs, combinations of drugs tested, small study
samples and patient population heterogeneity.
Conclusion: The currently available data do not unequivocally support a consistent effect of
novel antidiabetic agents on EF and PF. Further study is required ideally for the validation of
the results with clinical outcomes.
