Diabetes & Vascular Disease Research

We aimed to investigate preclinical atherosclerosis in T1D and its relationship with glucose profile and endothelial/ inflammatory markers. Thirty-eight T1D patients without additional cardiovascular risk factors or micro-/macrovascular complications and 22 healthy matched subjects were included. FMD and cIMT/fIMT were performed in addition to 72-h continuous glucose monitoring and the measurement of endothelial/inflammatory markers. Lower FMD percentages and greater cIMT/fIMT were observed in patients with T1D in comparison with controls (FMD 7.0±3.1% vs. 9.6±2.2%; p<0.005; cIMT 0.523±0.091 mm vs. 0.471±0.061 mm; p<0.05 and fIMT 0.512±0.172mm vs. 0.394±0.061mm; p<0.01, for patients and controls, respectively). T1D subjects in the highest tertile of cIMT were older than those in the lowest group (39.9±9.5 vs. 29.6±4.7 years; p<0.005) and had a longer duration of the disease (18.7±5.4 years vs. 11.8±6.4 years). The higher the cIMT tertile, the greater the fIMT (0.397±0.114 mm vs. 0.431±0.082 mm vs. 0.583±0.197 mm; p<0.05). MAGE was negatively correlated to FMD (r=-0.328; p<0.05) and positively to cIMT (r=0.322; p<0.05). There were no differences between cIMT tertiles in terms of metabolic parameters or endothelial and inflammatory markers. Signals of preclinical atherosclerosis in T1D even in the absence of cardiovascular risk factors and micro- / macrovascular disease are reported. Our findings suggest that daily glucose instability could negatively impact vascular function and structure.

In this study we tested the hypothesis that type 2 diabetes impairs the dynamic response of leg vascular conductance (LVC) during exercise. LVC (leg blood flow/mean arterial pressure) responses were studied during intermittent contractions of the calf muscle in subjects with type 2 diabetes (n = 9), heavy controls (n = 10) and lean controls (n = 8) using a biexponential function and an estimate of the mean response time (MRT). The time constant of the second phase of LVC was significantly greater in type 2 diabetes (66.4 ± 29.2 s) than the heavy (22.2 ± 13.4 s) and lean (21.8 ± 9.3 s) controls, resulting in a significantly greater MRT in the diabetic group (median [IQR] = 30.7 [24.6—46.5] s versus 16.3 [4.3—23.2] s and 18.4 [13.7—19.3] s). These data support the hypothesis and suggest that a slowed hyperaemic response in the exercising limb might contribute to exercise intolerance in diabetic subjects.

Background: The aim of this study was to assess the salivary content of lipid peroxidation and antioxidants in patients with type 2 diabetes.

Method: We studied 25 patients with type 2 diabetes and other 25 age- and sex-matched health control. To evaluate the oxidative status we measured the levels of malondialdehyde (MDA) in the saliva and serum of all participants. Lipid profile was also estimated through measuring total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels. Antioxidant levels were also assessed through measuring the salivary and serum concentration of uric acid, superoxide dismutase and reduced glutathione (GSH).

Results: The high concentration of lipid fractions in saliva usually follows that recorded in serum. Salivary MDA levels, a product of lipid peroxidation, were significantly increased among diabetics together with uric acid. However, GSH levels were similar to those of the control group.

Conclusion: Lipid peroxidation and antioxidant parameters assessed in saliva of diabetic patients may be of great importance in evaluating the disease activity and severity. The increase in lipid peroxidation and the tendency of antioxidants to rise in diabetes is probably due to an adaptive response to the pro-oxidant status of diabetes.

The aim of present study is to translate and validate a Chinese version of the WIQ in patients with PAD and T2DM. A cross-sectional survey was conducted. After translation, a convenience sample of 59 patients with PAD and T2DM completed the Chinese WIQ, the Chinese SF-36 and the 6MWT. The ICC and Cronbach’s alpha were calculated to determine the reliability and internal consistency, respectively.Validity was evaluated by correlation coefficients between WIQ, SF-36 and 6MWD. The internal consistency determined by Cronbach’s alpha was 0.93. Test—retest reliability expressed by ICC was 0.93. Significant correlations were observed between WIQ, SF-36 and 6MWD (ρ _s =0.27 ∼0.88, p < 0.01).The Chinese version of the WIQ has satisfactory reliability and validity and can be used to assess walking ability in type 2 diabetic PAD patients.

The relationship between insulin secretion and acute insulin resistance (as assessed by Homeostatic Model Assessment [HOMA] index) and clinical and biochemical parameters in the early phase of non-diabetic ST-elevation myocardial infarction (STEMI) is so far unexplored. We aimed at assessing this relation in 286 consecutive STEMI patients without previously known diabetes submitted to primary percutaneous coronary intervention (PCI). Insulin resistance (as indicated by HOMA) was detectable in 67.1%. Non-parametric correlation showed that HOMA index was significantly correlated with BMI (r = 0.242; p < 0.0001) and HbA_1c (r = 0.189; p < 0.001). At multivariable backward linear regression analysis, glycaemia was directly related to leukocyte count (p = 0.0003), age (p = 0.0001), creatine kinase isoform MB (CK-MB) (p = 0.00278) and lactate (p < 0.0001). Insulin was directly and significantly related to glycaemia (p = 0.0006), body mass index (BMI) (p = 0.00028) and lactate (p = 0.0096) In the early phase of STEMI without previously known diabetes the acute glucose dysmetabolism is quite complex, comprising increased glucose values and the development of acute insulin resistance. While insulin secretion is strictly related to BMI, apart from glucose levels, increased glucose values can be mainly related to the acute inflammatory response (as indicated to leukocyte count and C-RP), to age and to the degree of myocardial damage (as inferred by CK-MB)

Prehypertension is considered to be associated with increased cardiovascular disease (CVD), and some data suggest that insulin resistance is common in this group. The goal of this study was to quantify insulin action by determining the steady-state plasma glucose (SSPG) concentration during the insulin suppression test in apparently healthy individuals with prehypertension (n=126) and to elucidate the relationship between insulin action and CVD risk.We found a marked heterogeneity in insulin sensitivity in the prehypertension group, and when we divided the population into insulin-sensitive, insulin-resistant and intermediate groups, there were significant (p<0.01) increases in plasma glucose and triglyceride concentrations and decreases in high-density lipoprotein cholesterol concentrations with progressive degrees of insulin resistance. These data show that at least one-third of patients with prehypertension are insulin resistant, display the accompanying metabolic abnormalities, and merit enhanced surveillance and intensive efforts at therapeutic intervention to prevent CVD.

Objective: To assess the effect of metformin administration on thyroid function in overweight women with polycystic ovarian syndrome (PCOS).

Methods: Twenty-seven overweight women with PCOS and hypothyroidism were selected. Fifteen patients (group I) were treated with metformin 1500 mg/day for 6 months and 12 patients (group II) with placebo. Serum thyrotropin (TSH), free T3 and free T4 were measured at baseline and 6 months after the beginning of the study.

Results: A significant decrease (p<0.001) in TSH levels was observed in group I but not in group II subjects after 6 months of metformin treatment. No significant change in free T3 and free T4 was observed throughout the study in any group.

Conclusion: In obese PCOS patients with primary hypothyroidism, metformin results in a significant fall and sometimes normalisation of TSH, without causing any reciprocal changes in other thyroid function parameters.