METABOLIC, BODY COMPOSITION, AND INFLAMMATION OUTCOMES FOLLOWING SECOND-LINE ANTIDIABETIC THERAPIES IN TYPE 2 DIABETES MELLITUS: A ONE-YEAR PROSPECTIVE COHORT STUDY
IOANA BUJDEI-TEBEICĂ 1*, ANCA MIHAELA PANTEA-STOIAN 1,2, DOINA ANDRADA MIHAI 1,2, SIMONA DIANA ȘTEFAN 2, CRISTIAN SERAFINCEANU 1,²
¹ Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy “Carol Davila”, 030167 Bucharest, Romania
2 National Institute of Diabetes, Nutrition and Metabolic Diseases “Prof. N.C. Paulescu”, 030167 Bucharest, Romania
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Type 2 diabetes mellitus (T2DM) with obesity requires a comprehensive assessment spanning glycemic control, adiposity, muscle function, renal function, and low-grade inflammation. This prospective cohort study in Bucharest, Romania, evaluated one-year associations between metformin-based antidiabetic regimens and glycemic, body composition, functional, renal, and high-sensitivity C-reactive protein (hs-CRP) outcomes. Of 291 adults assessed, 166 completed 12-month follow-up without treatment change and were classified into six groups: metformin (n = 46), sulfonylurea (n = 10), DPP-4 inhibitor (n = 17), SGLT2 inhibitor (n = 25), GLP-1 receptor agonist (GLP-1 RA; n = 23), and insulin (n = 45). Outcomes were analyzed using baseline-adjusted regression with robust HC3 standard errors. Compared with metformin, GLP-1 RA therapy was associated with lower 12-month HbA1c (β = -0.745%), body weight (β = -5.246 kg), fat mass percentage (β = -2.731 points), and ln(hs- CRP) (β = -0.459), while handgrip strength and eGFR remained stable. GLP-1 RA showed the most favorable multidimensional profile, with no adverse muscle or renal effects. These findings support the integration of body composition and inflammatory markers into T2DM assessment, though the associations are observational rather than causal.
