| Summary: | Background: Recommendations for therapy of insulin resistance are metformin and
thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-
5% and increased 5-15% when combined with insulin therapy. Telmisartan, an
angiotensin receptor blocker, has anti-hypertensive effects and improve insulin
resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist
and has the same structure of the group thiazolidindion, pioglitazone. The research
objective was to determine the effects of telmisartan and metformin on insulin
resistance in metabolic syndrome patients with insulin therapy.
Methods: using a before-after design. The study was conducted in the internal
medicine clinic of the department of endocrinology Dr. Sardjito Hospital
Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome
based on the IDF 2005, hypertension and received insulin therapy. Subjects given
metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR
before and after treatment. The average decrease in HOMA IR was tested by paired
t-test or Wilcoxon tests. P value < 0.05 was considered significant.
Result: total sample were 27 subjects. Data analysis was performed on 11 subjects.
Fasting blood glucose before and after treatment was significantly decreased
(p<0,001) whereas the fasting insulin levels increased. HOMA IR was significantly
decreased after treatment {p = 0,004 (5,79 � 20,26), CI 95%}.
Conclusion: this study found decreased insulin resistance significantly in patients
with the metabolic syndrome of insulin therapy who received metformin and
telmisartan.
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