Post-Meal Hyperglycemia Induced Oxidative Stress Impairs Cardiac/Vascular Function by Increasing Myocardial Energy Demand in Non-Hypertensive People with Type 2 Diabetes – Assessed by Tissue Doppler and Wave Intensity

Bibra, H. von; Illmann, Alexander; Avgeropoulou, C.

doi:10.1007/978-3-642-03882-2_455

Cited by 1 publication

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may encompass additional infl uences such as infl ammation and structural modifi cations, which at this stage of the disease may limit endothelial reactivity measured as post-meal increase of VCAM. With regard to possible impact factors for diastolic function, there were two unexpected fi ndings: no correlation was observed between post-meal oxidative stress generation and diastolic function although this had recently been demonstrated in T2DM individuals without hypertension and heart disease [37] . But there were inverse associations with lipid levels before and after a pure carbohydrate meal in well-controlled T2DM patients without hyperlipidemia and with comparable lipid levels between groups.…”

Section: Post-meal Metabolismmentioning

confidence: 99%

Optimized Postprandial Glucose Control is Associated with Improved Cardiac/Vascular Function – Comparison of Three Insulin Regimens in Well-controlled Type 2 Diabetes

Bibra¹,

Siegmund²,

Ceriello³

et al. 2009

Horm Metab Res

View full text Add to dashboard Cite

In people with type 2 diabetes (T2DM), hyperglycemia has a negative impact on cardiac function and cardiovascular risk. Beneficial effects of improved postprandial glycemic control have been shown for cardiovascular risk only. To demonstrate these beneficial effects on myocardial function, we investigated well-controlled T2DM patients on three insulin regimens with different impact on postprandial glucose control. For 24 months, 61 T2DM participants in a randomized study had either conventional therapy (CT) with human premixed insulin b.d. (n=20), intensified therapy (ICT) with Lispro at meals and NPH at bedtime (n=24), or supplementary therapy (SIT) with human regular insulin at meals (n=17). Metabolism and cardiovascular function were assessed before and 2 hours after a standardized carbohydrate breakfast (48 g) using tissue Doppler to measure diastolic myocardial function (E'). Age, BMI, dose of insulin, cardiovascular disease, and medication were comparable between the groups. Hb1Ac was comparable with CT, ICT, and SIT (6.6+/-0.6, 6.2+/-0.6, and 6.4+/-0.7%) and so was fasting glucose. Post-meal glucose increment was 60+/-45 mg/dl with CT, but 15+/-52 and 8+/-58 mg/dl with ICT and SIT (p<0.006). E' was significantly lower (p<0.03) with CT (6.8+/-1.0 cm/s) vs. ICT (7.7+/-1.6) and SIT (7.8+/-1.2 cm/s), and correlated with post-meal glucose (r=-0.2644, p<0.046). Intima-media thickness and arterial stiffness parameters were higher in CT (p<0.04). In T2DM patients, the long-term insulin regimens CT, ICT, and SIT achieved overall good metabolic control with significant differences, however, in postprandial glucose increments. The regimens achieving better post-meal glucose control were associated with better myocardial/vascular function.

show abstract

Section: Post-meal Metabolismmentioning

confidence: 99%