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Effects of improved glycaemic control on endothelial function in patients with type 2 diabetes
Author(s) -
Bagg W.,
Whalley G. A.,
Gamble G.,
Drury P. L.,
Sharpe N.,
Braatvedt G. D.
Publication year - 2001
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1046/j.1445-5994.2001.00072.x
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , brachial artery , endothelial dysfunction , type 2 diabetes mellitus , endothelium , blood pressure , gastroenterology , endocrinology , cardiology
Background : Patients with type 2 diabetes have abnormal endothelial function but it is not certain whether improvements in glycaemic control will improve endothelial function. Aims : To examine the effects of short‐term improved glycaemic control on endothelial function in patients with inadequately regulated type 2 diabetes mellitus. Methods : Forty‐three patients with type 2 diabetes and glycosylated haemoglobin (HbA 1c ) > 8.9% were randomized to either improved glycaemic control (IC) n = 21 or usual glycaemic control (UC) n = 22 for 20 weeks. Using high‐resolution B‐mode ultrasound, brachial artery flow‐mediated dilatation (FMD) and glyceryl trinitrate‐mediated dilatation (GTN‐D) were measured at baseline and 20 weeks later. Results : After 20 weeks, HbA 1c was significantly lower in IC versus UC (IC 8.02 ± 0.25% versus UC 10.23 ± 0.23%, P < 0.0001) but changes in FMD and GTN‐D were not different between the groups (FMD at baseline and week 20 IC 5.1 ± 0.56% versus 4.9 ± 0.56% and UC 4.2 ± 0.51% versus 3.1 ± 0.51%; P = 0.23: GTN‐D IC 12.8 ± 1.34% versus 10.4 ± 1.32% and UC 13.7 ± 1.2% versus 12.7 ± 1.23%; P = 0.39). In the IC group weight increased by 3.2 ± 0.8 kg after 20 weeks compared to 0.02 ± 0.70 kg in UC ( P = 0.003). Blood pressure and serum lipid concentrations did not change in either group. Conclusions : Short‐term reduction of HbA 1c levels did not appear to affect endothelial function in patients with type 2 diabetes and previously poorly regulated glycaemic control. (Intern Med J 2001; 31: 322–328)