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Effect of acute hyperglycaemia, long‐term glycaemic control and insulin on endothelial dysfunction and inflammation in Type 1 diabetic patients with different characteristics
Author(s) -
Ceriello A.,
Esposito K.,
Ihnat M.,
Thorpe J.,
Giugliano D.
Publication year - 2010
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2009.02928.x
Subject(s) - medicine , endocrinology , diabetes mellitus , insulin , endothelial dysfunction , type 2 diabetes , inflammation , vitamin c
Diabet. Med. 27, 911–917 (2010) Abstract Objective To investigate the possibility of reversing endothelial dysfunction and inflammation by glucose normalization, antioxidants and insulin per se, in different subgroups of Type 1 diabetic patients. Methods Three subgroups of Type 1 diabetic patients were studied: patients within 1 month of diagnosis (subgroup 1); patients with approximately 5 years’ disease duration and with glycated haemoglobin (HbA 1c ) ≤ 7.0% (subgroup 2) or > 7.0% since diagnosis (subgroup 3). Participants underwent four procedures: 2‐h hyperglycaemic clamp followed by: (A) 12 h near‐normalization of blood glucose, with the addition of vitamin C during the last 6 h; (B) 12‐h vitamin C and near‐normalization of blood glucose for the last 6 h; (C) both vitamin C and near‐normalization of blood glucose for 12 h; (D) hyperglycaemic–hyperinsulinaemic clamp for 12 h, with the addition of vitamin C during the last 6 h. Results After 2 h of hyperglycaemia, markers of endothelial dysfunction, nitrotyrosine, 8‐iso prostaglandin F2α, soluble intercellular adhesion molecule‐1, soluble vascular adhesion molecule‐1, interleukin (IL)‐6 and IL‐18 were increased in all the subgroups. Levels were normalized, at all time points, by treatments A, B and C in the subgroups 1 and 2. In the third subgroup, levels were normalized only by the simultaneous normalization of blood glucose and vitamin C treatment. During treatment D, the levels were improved at 6 h in all the subgroups, but normalized at 12 h only after vitamin C in subgroups 1 and 2, but not in subgroup 3. Conclusions This study suggests that different subgroups of Type 1 diabetic patients react identically to acute hyperglycaemia and insulin, but differently to glucose normalization.