Effects of insulin analogs as an add-on to metformin on cutaneous microcirculation in type 2 diabetic patients

Fysekidis, Marinos; Cosson, E.; Takbou, K.; Sutton, Angéla; Charnaux, Nathalie; Banu, Isabella; Vicaut, Éric; Valensi, P.

doi:10.1016/j.mvr.2017.09.005

Cited by 8 publications

(4 citation statements)

References 51 publications

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“…In Study 1, baseline CBF levels (at rest and after acetylcholine) measured on the forearm were similar to published results in patients with poorly controlled type 2 diabetes [27]. Baseline CBF levels were higher in Study 2 which could be due to the characteristics of arteriovenous anastomoses at palmar sites due to it glabrous properties [28].…”

Section: Discussionsupporting

confidence: 82%

Effects of single and multiple sessions of lower body diastole-synchronized compressions using a pulsating pneumatic suit on endothelium function and metabolic parameters in patients with type 2 diabetes: two controlled cross-over studies

Valensi¹,

Barber‐Chamoux

Rezki³

et al. 2022

Cardiovasc Diabetol

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Background Endothelium function is often impaired in patients with type 2 diabetes. We hypothesized that by improving endothelial function using diastole-synchronized compressions/decompressions (DSCD) to the lower body may improve the metabolic profile. The objective of this research was to evaluate the effects of single and multiple DSCD sessions on microcirculation, endothelium function and metabolic parameters of patients with type 2 diabetes. Methods Two monocentric, controlled, randomized cross-over studies (Study 1 and Study 2) were performed. In Study 1, 16 patients received one 20 min DSCD and one simulated (control) session at 2 week intervals; continuous glucose monitoring and cutaneous blood flow were recorded continuously before, during and after DSCD or Control session; other vascular assessments were performed before and after DSCD and control sessions. In Study 2, 38 patients received 60 min DSCD sessions three times/week for three months followed by a 4–6 week washout and 3 month control period (without simulated sessions); vascular, metabolic, body composition, physical activity and quality of life assessments were performed before and after 3 months. Results Both studies showed significant, multiplex effects of DSCD sessions. In Study 1, cutaneous blood flow and endothelium function increased, and plasma and interstitial glucose levels after a standard breakfast decreased after DSCD sessions. In Study 2, cutaneous endothelium function improved, LDL-cholesterol and non-HDL cholesterol decreased, extra-cell water decreased and SF-36 Vitality score increased after 3 months of DSCD sessions. Conclusions Our findings support the beneficial effect of DSCD on the endothelium and show concomitant beneficial metabolic and vitality effects. Future clinical trials need to test whether DSCD use translates into a preventive measure against microvascular diabetic complications and its progression. Trial registration ClinicalTrials.gov identifiers: NCT02293135 and NCT02359461.

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Section: Discussionsupporting

confidence: 82%

Effects of single and multiple sessions of lower body diastole-synchronized compressions using a pulsating pneumatic suit on endothelium function and metabolic parameters in patients with type 2 diabetes: two controlled cross-over studies

Valensi¹,

Barber‐Chamoux

Rezki³

et al. 2022

Cardiovasc Diabetol

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“…Ach chloride was diluted in 1 mL of sterile water, after which 200 µL of this solution was placed into a special chamber of a sponge that was used for skin application. After Ach administration, we measured i) maximal CBF, ii) CBF incremental area under the curve 3 min after Ach administration, which is considered an integrator of microvascular endothelial function, iii) delay from Ach administration to maximal CBF (peak delay), iv) peak tangent from basal to maximal CBF (tangent increase represents acceleration in tissue perfusion), and v) vasodilation duration from Ach administration until return to levels at least 20% higher than those for basal CBF 34…”

Section: Methodsmentioning

confidence: 99%

<p>Association Between Adherence To The French Dietary Guidelines And Lower Resting Heart Rate, Longer Diastole Duration, And Lower Myocardial Oxygen Consumption. The NUTRIVASC Study</p>

Fysekidis¹,

Kesse‐Guyot²,

Valensi³

et al. 2019

VHRM

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BackgroundTo investigate whether chronic adherence to the French Nutrition and Health Program (PNNS) guidelines was associated with better cardiovascular health.MethodsA study nested within the SU.VI.MAX2 cohort was conducted on participants without cardiovascular risk factors. Long-term adherence to the PNNS guidelines was estimated using validated dietary scores from 2007 and 2012. Individuals who did (PNNS+) and did not (PNNS−) continuously adhere to the PNNS guidelines were included. Applanation tonometry, impedance cardiography, laser doppler flowmetry, heart rate, heart rate variability, endothelial function was used for the assessment of cardiovascular health.ResultsA total of 49 subjects (mean age 65.4 ± 5.6 years, 75.5% women) had been included. Those in the PNNS+ group (n=26) were older, had a higher BMI and fat mass than those in the PNNS− group, both groups had similar metabolic parameters. After adjusting for sex, age, and BMI, PNNS+ subjects were found to have a lower heart rate (60.2 ± 8.0 vs 64.3 ± 8.4 beats/min, p=0.042), a lower heart rate × systolic blood pressure product (7166 ± 1323 vs 7788 ± 1680 beats× mmHg/min, p = 0.009), a longer diastole duration (66.7 ± 3.1% vs 64.6 ± 4.1% of the cardiac cycle duration, p=0.049), and a shorter tension–time index (2145 ± 489 vs 2307 ± 428 ms * mmHg, p=0.018) compared to the PNNS− group.ConclusionLong-term adherence to the PNNS guidelines had a favorable impact on heart rate, diastole duration, and myocardial oxygen consumption.Clinical Trial Registration numberNCT01579409.

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“…Амплитуды данных гармоник позволяют судить о функции локальных и системных механизмов модуляции микроциркуляции. В частности, с помощью ЛДФ показано, что инсулинотерапия может оказывать влияние на состояние микроциркуляции даже в краткосрочном периоде [9]. В различных исследованиях было показано, что наибольшей значимостью для диагностики диабетической микроангиопатии обладает низкочастотный диапазон амплитудно-частотного спектра (0,021-0,2 Гц) [5,8,10].…”

Section: ____________________________________________________________...unclassified

Лазерная Допплеровская Флоуметрия В Оценке Локальных Механизмов Микроциркуляции У Пациентов С Сахарным Диабетом 2-Го Типа, Осложненным Синдромом Диабетической Стопы И Хронической Болезнью Почек

Васильев¹,

Ерофеев²,

Shishkin³

2021

Кардиология В Беларуси

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Цель. Проанализировать изменения показателей низкочастотной части спектра сигнала лазерной допплеровской флоуметрии (ЛДФ) у пациентов с диабетической микроангиопатией и выявить их корреляции со скоростью клубочковой фильтрации. Материалы и методы. В исследование были включены 42 пациента с синдромом диабетической стопы на фоне сахарного диабета 2-го типа в возрасте 58-77 лет с хронической болезнью почек стадии С3-С4. У каждого пациента выполнялась регистрация ЛДФ-граммы c последующим спектральным анализом и оценкой корреляций его показателей с расчетной скоростью клубочковой фильтрации, на основании этого составлялось заключение об особенностях нарушений микроциркуляции. Результаты. При анализе показателей вклада миогенных и нейрогенных флаксмоций в общую мощность низкочастотного диапазона была отмечена отрицательная корреляция для вклада нейрогенных флаксмоций и положительная - для вклада миогенных флаксмоций (p<0,05). Параллельно в 6 наблюдениях отмечалась тенденция к уменьшению амплитуды эндотелиальных флаксмоций по мере снижения скорости клубочковой фильтрации. Заключение. В ходе настоящего исследования была опробована новая методика оценки вклада компонентов низкочастотного диапазона. Установлено, что у пациентов с хронической болезнью почек стадии С3-С4 по мере снижения скорости клубочковой фильтрации отмечалось снижение вклада миогенных флаксмоций и повышение вклада нейрогенных флаксмоций в общую мощность низкочастотного диапазона амплитудно-частотного спектра ЛДФ-сигнала. Вышеуказанные изменения могут быть объяснены поражением гладкомышечного слоя стенки артериол и венул с повреждением миоцитов-пейсмекеров и нарушением базального тонуса сосудов. Purpose. To analyze changes in the low-frequency part of the spectrum of the laser Doppler flowmetry (LDF) signal in patients with diabetic microangiopathy and to identify their correlations with glomerular filtration rate. Materials and methods. The study included 42 patients (20 men and 22 women) with type 2 diabetes mellitus and diabetic foot syndrome, aged 58-77 years, with chronic kidney disease of the stage C3- C4. Each patient performed the LDF registration followed by spectral analysis and assessment of its indicators with the estimated glomerular filtration rate. The features of microcirculation disorders were revealed on the base of it. Results. There were no significant correlations between the glomerular filtration rate and the amplitudes of myogenic and neurogenic flux motions (p>0.05). However, there was a significant positive correlation between the contribution of myogenic flux motions to the low-frequency range and glomerular filtration rate; and a negative one - for the contribution of neurogenic flux motions (p<0.05). In six observations, there was a tendency to decrease of the amplitude of endothelial flux motions as the glomerular filtration rate decreased. Conclusion. In the course of this study, a new technique for assessing the contribution of the low- frequency range components was tested. In patients with chronic kidney disease of the C3-C4 stage, decrease of the glomerular filtration rate correlated with the decrease of the contribution of myogenic flux motions and increase of the contribution of neurogenic flux motions to the total power of the low-frequency part of the amplitude-frequency spectrum of the LDF signal. These changes can be explained by damage to the smooth muscle layer of the wall of arterioles and venules with damage to pacemaker myocytes and violation of the basal vascular tone.

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Effects of insulin analogs as an add-on to metformin on cutaneous microcirculation in type 2 diabetic patients

Cited by 8 publications

References 51 publications

Effects of single and multiple sessions of lower body diastole-synchronized compressions using a pulsating pneumatic suit on endothelium function and metabolic parameters in patients with type 2 diabetes: two controlled cross-over studies

Effects of single and multiple sessions of lower body diastole-synchronized compressions using a pulsating pneumatic suit on endothelium function and metabolic parameters in patients with type 2 diabetes: two controlled cross-over studies

<p>Association Between Adherence To The French Dietary Guidelines And Lower Resting Heart Rate, Longer Diastole Duration, And Lower Myocardial Oxygen Consumption. The NUTRIVASC Study</p>

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