WASHINGTON, DC—Treatment with sacubitril/valsartan resulted in a greater reduction in glycated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM), compared to treatment with enalapril. These study results, from the PARADIGM-HF trial, were presented at the ACC.17 Scientific Session.

In addition to improving morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), previous research in obese hypertensive patients has shown that sacubitril/valsartan, a combination of neprilysin inhibitor and angiotensin II receptor blocker, may improve peripheral insulin sensitivity. 

In the study, Jelena Seferovic, from Brigham and Women’s Hospital, Boston, MA and coauthors sought to find out the effects of treatment with sacubitril/valsartan on glycemic control in patients with HFrEF with known T2DM or an HbA1c ≥6.5% at the time of screening, compared to treatment with enalapril.

At the screening visit, there was no difference in HbA1c levels between the two treatment groups (enalapril [n=1874]: 7.5±1.6; sacubitril/valsartan [n=1904]: 7.4±1.5; P=0.14). In the follow-up visits, both treatment groups showed a significant decrease in HbA1c (P<0.001), however, patients in the sacubitril/valsartan group demonstrated a greater decline compared to the enalapril group (overall P=0.001). Study authors also noted a non-significant reduction in plasma glucose was also noted in the sacubitril/valsartan arm.

“These data suggest that sacubitril/valsartan could enhance glycemic control in patients with T2DM and HFrEF, ” Seferovic concluded.