New research suggest that Trajenta (linagliptin), a dipeptidyl peptidase-4 (DPP-4) inhibitor used to lower blood sugars in people with type 2 diabetes, may reduce damage to the heart from metabolic dysfunction.
The drug was shown in mice to prevent the stiffening of the heart muscle leading to heart disease complications that people with type 2 diabetes are more prone to develop.
The hardening of the ventricles of the heart is one of the initial symptoms of a weak heart muscle and the sign of advanced atherosclerosis or narrowing of the arteries.
In the journal Cardiovascular Diabetology, researchers at the University of Missouri-School of Medicine tie vascular stiffness to our high-sugar Western food environment.
High-sugar diets are a big contributor to hyperinsulinemia, hyperglycemia and insulin resistance, all of which are known risk factors for heart disease.
The mechanisms are vastly complex but it is thought that hyperinsulinemia alters the body’s handling of blood lipids such that there is an overproduction of triglycerides, which promotes inflammation.
Hyperinsulinemia also raises blood pressure by decreasing sodium and water excretion in the kidneys, and directly vasoconstriting blood vessels. Vasoconstriction in turn increases heart stiffness.
Because hyperinsulinemia often correlates with body fat accumulatio, people who are overweight or obese tend to have higher risks for cardiovascular disease (CVD).
Since insulin dysregulation appears to be an important biomarker for predicting CVD risks, this new study tested whether linagliptin – known to improve insulin sensitivity – may prevent the stiffening of the heart.
Researchers fed 34 female obese mice a Western type of diet for four months. Another group of mice were fed the same diet, the only difference being that it contained a low dose of linagliptin.
The experiment, in which an ultrasound system was used to evaluate the function of of the heart, showed that mice fed the Western diet alone displayed signs of heart dysfunction while those fed the diet along with linagliptin did not.
In addition to that, linagliptin seemed to decrease oxidative stress and inflammation in the animals’s hearts, overall suggesting that linagliptin may provide some CVD protection.
It is also becoming increasingly clear that lifestyle changes, including low-carb diets, are effective to address underlying causes of insulin resistance and improve cardiovacular outcomes in type 2 diabetes.

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