Post-meal coagulation activation in diabetes mellitus: the effect of acarbose

Ceriello, Antonio; Taboga, C.; Tonutti, Laura; Giacomello, Roberta; Stel, L.; Motz, Enrico; Pirisi, Mario

doi:10.1007/bf00400679

Cited by 107 publications

(39 citation statements)

References 35 publications

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“…These free radicals induce a biochemical cascade resulting in increased inflammation, hypercoaguability and endothelial dysfunction that favors vasoconstriction and elevation of blood pressure, leading to diabetes and early cardiovascular disease (Ceriello et al, 1996;Monnier et al, 2006;O'Keefe and Bell, 2007;O'Keefe et al, 2008). Improvements in postprandial glycemia and the increase in satiety observed in this study can at least in part offer explanation for reductions in blood pressure, inflammatory and coagulation factors observed in our longer-term study with Salba (Vuksan et al, 2007).…”

Section: Discussionmentioning

confidence: 52%

Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)

et al. 2010

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Despite strong correlations linking whole-grain consumption to reductions in heart disease, the physiological mechanisms involved remain ambiguous. We assessed whether Salba (Salvia Hispanica L.) whole grain reduces postprandial glycemia in healthy subjects, as a possible explanation for its cardioprotective effects observed in individuals with diabetes. The study used acute, randomized, double-blind, controlled design in which 11 healthy individuals (6 males and 5 females; body mass index 22.3 ± 2.8 kg/m 2 ) received 0, 7, 15 or 24 g of Salba baked into white bread. Capillary samples and appetite ratings were collected over 2 h after consumption. A dose-response reduction in postprandial glycemia (P ¼ 0.002, r 2 ¼ 0.203) was observed with all three doses of Salba, significantly decreasing incremental areas under the curve (iAUCs) and time point-specific blood glucose (Po0.05). Appetite ratings were decreased at 60 min after high, 90 min after high and intermediate and at 120 min after all treatments (Po0.05). Decrease in postprandial glycemia provides a potential explanation for improvements in blood pressure, coagulation and inflammatory markers previously observed after 12-week Salba supplementation in type II diabetes.

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Section: Discussionmentioning

confidence: 52%

Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)

et al. 2010

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“…This is based on a previous study in which the standard deviation of F1 + 2 AUC was 150 nmol ⁄ l · min. [27]. Results for insulin, FFA, triglycerides, LDL cholesterol, CRP, ICAM, vWF and total insulin dose were logarithmically transformed before analysis.…”

Section: Different Insulin Regimens and Postprandial Arterial Wall Dymentioning

confidence: 99%

Effects of Mealtime Insulin Aspart and Bedtime NPH Insulin on Postprandial Inflammation and Endothelial Cell Function in Patients with Type 2 Diabetes

Bladbjerg

Henriksen

Akram

et al. 2011

Basic &Amp; Clinical Pharmacology &Amp; Toxicology

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Acute hyperglycaemia exerts deleterious effects on the arterial wall. We suggested that rapid-acting insulin has a beneficial postprandial effect on endothelial dysfunction and inflammation compared with intermediate-acting insulin because of its ability to lower postprandial hyperglycaemia. This was tested in a parallel, controlled study on well-controlled patients with type 2 diabetes randomly assigned to bedtime Neutral Protamine Hagedorn (NPH) insulin (n = 41) or mealtime insulin aspart (n = 37). They were served standard diabetic meals for breakfast (8.00) and lunch (12.00). Blood samples were collected at 7.40 (fasting), 9.30, 11.30, 13.30 and 15.30 and analysed for glucose, insulin, lipids, intercellular adhesion molecules (ICAM), C-reactive protein (CRP), von Willebrand factor (vWF) and fibrinogen. The postprandial glucose response differed significantly between insulin regimens with a postprandial increase on NPH insulin and a decrease on insulin aspart. There was a minor but significant postprandial decrease in ICAM, CRP and vWF on both insulin regimens and a decrease in fibrinogen on NPH insulin. No insulin group differences were observed in postprandial responses for ICAM, CRP, vWF and fibrinogen. The rapid-acting insulin analogue aspart and the intermediate-acting insulin NPH had different effects on postprandial glucose response but similar postprandial effects on markers of inflammation and endothelial dysfunction.Type 2 diabetes is associated with increased risk of cardiovascular disease [1]. There is a strong relationship between postprandial hyperglycaemia and the risk of cardiovascular disease in epidemiological studies where postprandial hyperglycaemia is more important than fasting blood glucose or HbA1c as predictors [2][3][4][5]. However, this concept has recently been challenged [6,7] and is still highly debated [8,9].Experimental data indicate that acute hyperglycaemia can exert deleterious effects on the arterial wall measured as flow-mediated vasodilatation [10][11][12]. In line with this, the link between acute hyperglycaemia and inflammation and endothelial cell dysfunction has been investigated, showing an acute increase in interleukin 6 (IL-6) and tumour necrosis factor alfa (TNFa) [ [21] or by the antioxidant glutathione [13,14]. In these studies, the hypoglycaemic agent was compared with placebo, and different treatment regimens have not been compared. It is assumed that pharmacological agents directed towards postprandial hyperglycaemia will be more effective in reducing postprandial inflammation and endothelial cell dysfunction than treatment directed towards fasting hyperglycaemia.The aim of this short-term study in well-controlled patients with type 2 diabetes was to compare the acute effect of two different insulin treatment regimens on postprandial inflammation and endothelial cell function evaluated by biochemical markers. We suggested that the rapid-acting insulin analogue insulin aspart, directed towards postprandial hyperglycaemia, has a beneficial postprandi...

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“…24,25 Ceriello et al and others have shown that postprandial hyperglycemia is associated with an increase in tissue oxidative stress. [26][27][28][29] This appeared to be true not only for DM patients, but also for individuals with IGT. 30,31 Hyperglycemia-induced oxidative stress might induce endothelial dysfunction, resulting in pathological damage to the cardiovascular system.…”

Section: Hyperglycemia and Cardiovascular Injurymentioning

confidence: 99%

Impact of Newly Diagnosed Abnormal Glucose Tolerance on Long-Term Prognosis in Patients With Acute Myocardial Infarction

Tamita¹,

Katayama²,

Takagi³

et al. 2007

Circ J

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ompared to individuals without diabetes mellitus (DM), DM patients have approximately a 2-fold higher risk of short-term mortality after acute myocardial infarction (AMI). 1,2 In the current reperfusion era, over 90% of DM patients survive the early 30-day period; however, these patients are prone to markedly-increased mortality after 6 th months. 3,4 The results of several clinical studies indicate that even people with pre-diabetic conditions, such as impaired glucose tolerance (IGT), have increased risks for cardiovascular disease. 5-8 A recent metaregression analysis reported a continuous relationship between 2h-postchallenge glucose levels and cardiovascular risk below the diabetic threshold, and there is growing epidemiological evidence for the association of postchallenge hyperglycemia and macrovascular complications. [9][10][11][12][13] Recently, the Glucose Tolerance in Patients with Acute Myocardial Infarction (GAMI) study revealed that abnormal glucose tolerance, determined by the presence of postchallenge hyperglycemia, was common among patients with AMI and is a risk factor for future cardiovascular events. 14,15 However, the impact of newly-diagnosed abnormal glucose tolerance on the long-term prognosis after AMI has not been fully demonstrated. The aim of the present study, therefore, was to determine whether newlydiagnosed abnormal glucose tolerance affects long-term clinical outcomes after AMI relative to AMI patients with normal glucose tolerance or with previously diagnosed DM in the current clinical settings. Methods Study PatientsWe enrolled 384 consecutive patients with AMI admitted to the coronary care unit of Kobe General Hospital, Japan, from August 1997 to December 2000. We excluded all individuals who were older than 80 years old, or who had serum creatinine concentrations higher than 2.0 mg/dl or other inhospital major adverse clinical events, including cardiogenic shock and emergency coronary artery bypass grafting. Of the 384 consecutive patients screened, 109 patients were excluded due to in-hospital death (n=34), stroke (n=2), emergency coronary artery bypass surgery (n=22), left ventricular (LV) reconstruction surgery (n=2), non-fatal LV rupture (n=5), recurrent percutaneous coronary intervention (PCI; n=3), concomitant disease (n=6, idiopathic dilated cardiomyopathy, neoplasm, schizophrenia, hypoxic brain damage), chronic renal failure (n=7), age over 80 years old (n=8) and unwillingness to enter the study (n=20). The study protocol was approved by the Committee for the Protection of Human Subjects in Research at Kobe General Hospital. Written informed consent was obtained from all individuals. Background Newly-diagnosed diabetes mellitus (DM) and impaired glucose tolerance are common among patients with acute myocardial infarction (AMI). However, its significance on long-term clinical outcomes in those patients remains unclear. The present study was designed to determine whether such abnormalities after AMI affect long-term clinical outcomes. Methods and ResultsTwo-hundred and ...

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Post-meal coagulation activation in diabetes mellitus: the effect of acarbose

Cited by 107 publications

References 35 publications

Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)

Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)

Effects of Mealtime Insulin Aspart and Bedtime NPH Insulin on Postprandial Inflammation and Endothelial Cell Function in Patients with Type 2 Diabetes

Impact of Newly Diagnosed Abnormal Glucose Tolerance on Long-Term Prognosis in Patients With Acute Myocardial Infarction

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