Family History of Diabetes Is a Major Determinant of Endothelial Function

Goldfine, Allison B.; Beckman, Joshua A.; Betensky, Rebecca A.; Devlin, Heather M.; Hurley, Shauna; Varo, Nerea; Schönbeck, Uwe; Patti, Mary Elizabeth; Creager, Mark A.

doi:10.1016/j.jacc.2006.02.045

Cited by 81 publications

(82 citation statements)

References 20 publications

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“…Furthermore, our data seem to confirm that early and continuous aggressive treatment of glycemia is important to avoid future complications. Incidentally, in our opinion, the recent findings showing the existence of a continuum between the values of glycemia, endothelial dysfunction, and the risk of a cardiovascular event, even in nondiabetic patients, supports this concept (39,40).…”

Section: Ceriello and Associatesmentioning

confidence: 60%

Telmisartan Shows an Equivalent Effect of Vitamin C in Further Improving Endothelial Dysfunction After Glycemia Normalization in Type 1 Diabetes

Ceriello

Piconi²,

Esposito

et al. 2007

Diabetes Care

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OBJECTIVE -Long-lasting hyperglycemia in type 1 diabetic patients induces permanent alterations of endothelial function by increased oxidative stress, even when glycemia is normalized.RESEARCH DESIGN AND METHODS -In this study, 36 type 1 diabetic patients and 12 control subjects were enrolled. The diabetic patients were divided into three groups. The first group was treated for 24 h with insulin, achieving a near normalization of glycemia. After 12 h of this treatment, vitamin C was added for the remaining 12 h. The second group was treated for 24 h with vitamin C. After 12 h of this treatment, insulin was started, achieving a near normalization of glycemia for the remaining 12 h. The third group was treated for 24 h with both vitamin C and insulin, achieving near normalization of glycemia. The same protocols were performed after 1 month of telmisartan or placebo.RESULTS -Neither normalization of glycemia nor vitamin C treatment alone was able to normalize endothelial dysfunction or oxidative stress. Combining insulin and vitamin C normalized endothelial dysfunction and decreased oxidative stress to normal levels. Telmisartan significantly improved basal endothelial function and decreased nitrotyrosine plasma levels. In patients treated with telmisartan, a near normalization of both flow-mediated vasodilation and oxidative stress was achieved when glycemia was normalized, whereas adding vitamin C infusion did not show further effect on endothelial function or nitrotyrosine plasma levels.CONCLUSIONS -These data indicate that combining the normalization of glycemia with an antioxidant can normalize endothelial function in type 1 diabetic patients and that telmisartan works as an antioxidant like vitamin C. Diabetes Care 30:1694-1698, 2007A n increase in the incidence of macrovascular diseases in type 1 diabetes has long been recognized (1). The acceleration of macrovascular disease is partly due to the increased incidence of classical risk factors such as hypertension and dyslipidemia (2). However, recent evidence suggests that hyperglycemia also plays a significant role (3).The endothelium is a major organ involved in the development of cardiovascular disease (CVD), even in diabetes, and the presence of endothelial dysfunction has often been reported in diabetes and been found to be an independent predictor of future CVD (4).Several studies have shown that hyperglycemia induces endothelial dysfunction in both diabetic and nondiabetic subjects (5-7); however, in type 1 diabetic patients, endothelial dysfunction has been reported to be present, even when normoglycemia is achieved (8,9).Evidence indicates that hyperglycemia induces endothelial dysfunction through the generation of oxidative stress (10), which has been suggested to be the key player in the generation of both micro-and macrovascular diabetes complications (11). We have recently demonstrated that a near normalization of endothelial dysfunction can be achieved in type 1 diabetic patients by combining an optimal control of glycemia with the infusion of t...

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Section: Ceriello and Associatesmentioning

confidence: 60%

Telmisartan Shows an Equivalent Effect of Vitamin C in Further Improving Endothelial Dysfunction After Glycemia Normalization in Type 1 Diabetes

Ceriello

Piconi²,

Esposito

et al. 2007

Diabetes Care

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“…13 In support of the consistent epidemiologic findings about family history, a wide range of metabolic studies have reported early signs of abnormalities among otherwise healthy people who have a family history of diabetes. Persons with a positive family history of diabetes, including children, might show early signs of defective insulin actions, [14][15][16][17][18] glucose intolerance, 19,20 lipid abnormalities, high BP, large weight gains, 21 reduced ␤-cell function, 20,22 impaired endothelial function, 23 and altered energy (mitochondrial) metabolism. [24][25][26][27] The epidemiologic evidence for the familial aggregation of CVD is also strong.…”

Section: Family History As An Independent Risk Factor For Type 2 Diabmentioning

confidence: 99%

Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

et al. 2007

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Several studies indicate that the risk for type 2 diabetes or cardiovascular disease is detectable in childhood, although these disorders may not emerge until adulthood. In addition, type 2 diabetes and cardiovascular disease seem to share risk factors, including obesity and dyslipidemia, and might even share etiology, which has important implications for screening and prevention strategies for both diseases. Primary prevention, in particular, has gained importance because the results of major randomized, controlled trials strongly suggest that, at least in high-risk adult groups, type 2 diabetes can be prevented or delayed. Furthermore, some intervention studies indicate that the risk factors for diabetes and cardiovascular disease can be reduced in children. A simple way to detect risk for either diabetes or cardiovascular disease is to examine the family history. Numerous studies have shown that adults who have 1 or more first-or second-degree relatives affected with diabetes or cardiovascular disease are at high risk of having or developing these diseases. Currently, there are no overall screening strategies recommended for either diabetes or cardiovascular disease among children and adolescents. The evidence is strong, however, that youth with a positive family history already show signs of increased risk for these conditions. Family history can be part of the approach to screening for children at risk of diabetes and cardiovascular disease and should be part of prevention campaigns aimed at reducing the burden of these diseases and their risk factors in children.www.pediatrics.org/cgi

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“…Although this is not supported by strong scientific evidence, many observational studies have revealed its relationship with increased cardiovascular risk [21]. For instance, several workers have confirmed significant endothelial dysfunction in subjects with parental history of type 2 DM [26][27][28][29], although another study has reported a contrasting finding [30]. Nevertheless, an association between carotid intima-media thickness (CIMT) and risk factors for atherosclerosis has been documented by some investigators [31]; underscoring the role of family history of type 2 DM on development of cardiovascular risk.…”

Section: Obesity and Type 2 Diabetes Mellitus: The Nexusmentioning

confidence: 99%

Childhood Diabetes Mellitus and the Double Burden of Malnutrition: An Emerging Public Health Challenge in Developing Countries

Uwaezuoke¹

2015

J Diabetes Metab

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The 'double burden of malnutrition' refers to the simultaneous existence of both undernutrition and overnutrition in the same population across the life course. Diabetes mellitus (DM) -a major non-communicable disease -has been linked to both chronic undernutrition and obesity; the latter is now assuming prominence in developing countries. The present review aims to highlight the global burden of this non-communicable disease in children and its relationship with the 'double burden of malnutrition'. Type 2 DM has rapidly evolved from a disease of the Western world to a global disease; from a disease of affluence to a disease that now afflicts the poor; and from an adult-onset disease to a disease that is gaining prominence in the pediatric population. Estimates from the International Diabetes Federation show that diabetes affects at least 285 million people worldwide out of which two-thirds occur in developing (low-to middle-income) countries. The global epicenter of diabetes epidemic is located in China and India as Asia has undergone rapid economic development, urbanization and transitions in nutritional status. Overweight and obesity are propelling the worldwide diabetes epidemic. Central obesity is correlated with both insulin resistance and type 2 DM. Moreover, the scourge of chronic undernutrition among children in tropical developing countries may predispose them to malnutrition-modulated diabetes mellitus (MMDM) later in life. Children in these regions are thus faced with a health-related dilemma. There is an urgent need to develop a comprehensive prevention program targeted at reducing diabetes risk and promoting proper nutrition among children in these countries.

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Family History of Diabetes Is a Major Determinant of Endothelial Function

Abstract: Bioavailability of nitric oxide is lower in persons with a strong FH of T2D. Glycemic burden, even in the nondiabetic range, can contribute to endothelial dysfunction. Abnormalities of endothelial function may contribute to atherosclerosis before development of overt diabetes.

Cited by 81 publications

References 20 publications

Telmisartan Shows an Equivalent Effect of Vitamin C in Further Improving Endothelial Dysfunction After Glycemia Normalization in Type 1 Diabetes

Telmisartan Shows an Equivalent Effect of Vitamin C in Further Improving Endothelial Dysfunction After Glycemia Normalization in Type 1 Diabetes

Is Family History a Useful Tool for Detecting Children at Risk for Diabetes and Cardiovascular Diseases? A Public Health Perspective

Childhood Diabetes Mellitus and the Double Burden of Malnutrition: An Emerging Public Health Challenge in Developing Countries

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