92-LB: Linagliptin Improves CD34+ Progenitor Cells and Urine Exosomes

Introduction: Endothelial Progenitor cells (EPCs) has been shown to be dysfunctional in both type 2 diabetes and chronic kidney disease (CKD) leading to poor regeneration of endothelium. EPCs have been shown to be a robust cardiovascular disease (CVD) risk indicator. Cellular mechanisms of DPP-4 inhibitors such as Linagliptin (LG) on CVD risk in patients with type 2 diabetes with established CKD has not been established. Hypothesis: Linagliptin, a DPP-4 inhibitor when added to insulin, metformin or both may improve endothelial dysfunction in a diabetic kidney disease (DKD) Methods: 31 subjects taking metformin and/or Insulin were enrolled in this 12 weeks, double blind, randomized placebo matched trial, with 5 mg LG compared to placebo. Type 2 DM subjects (30-70 years old), A1c of 6.5-10%, CKD Stage 1-3 were included. CD34+ cell number, migratory function, gene expression along with vascular parameters such as Arterial stiffness, biochemistry, resting energy expenditure were measured. Data were collected at week 0, 6 and 12. A mixed model regression analysis was done with p value