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RESEARCH PRODUCT

Influence of glucose control and improvement of insulin resistance on microvascular blood flow and endothelial function in patients with diabetes mellitus type 2.

Clothilde HohbergThomas ForstAndreas PfütznerChristian SacharaPeter H. KannGeorg LübbenReiner RoßkopfChristiane FriedrichVolker Gottschall

subject

AdultBlood GlucoseMalemedicine.medical_specialtyEndotheliumPhysiologyArbitrary unitInsulin resistancePhysiology (medical)Diabetes mellitusInternal medicinemedicineHumansHypoglycemic AgentsMolecular BiologyAgedPioglitazonebusiness.industryMicrocirculationGlucose clamp techniqueMiddle Agedmedicine.diseaseGlimepirideEndocrinologymedicine.anatomical_structureSulfonylurea CompoundsDiabetes Mellitus Type 2Metabolic control analysisGlucose Clamp TechniqueFemaleThiazolidinedionesEndothelium VascularInsulin ResistanceCardiology and Cardiovascular MedicinebusinessPioglitazoneBlood Flow Velocitymedicine.drug

description

The study was performed to investigate the effect of improving metabolic control with pioglitazone in comparison to glimepiride on microvascular function in patients with diabetes mellitus type 2.A total of 179 patients were recruited and randomly assigned to one treatment group. Metabolic control (HbA1c), insulin resistance (HOMA index), and microvascular function (laser Doppler fluxmetry) were observed at baseline and after 3 and 6 months.HbA1c improved in both treatment arms (pioglitazone: 7.52 +/- 0.85% to 6.71 +/- 0.89%, p.0001; glimepiride: 7.44 +/- 0.89% to 6.83 +/- 0.85%, p.0001). Insulin-resistance decreased significantly in the pioglitazone group (6.15 +/- 4.05 to 3.85 +/- 1.92, p.0001) and remained unchanged in the glimepiride group. The microvascular response to heat significantly improved in both treatment groups (pioglitazone 48.5 [15.2; 91.8] to 88.8 [57.6; 124.1] arbitrary units [AU], p.0001; glimepiride 53.7 [14.1; 91.9] to 87.9 [52.9, 131.0] AU, p.0001, median [lower and upper quartile]). Endothelial function as measured with the acetylcholine response improved in the pioglitazone group (38.5 [22.2; 68.0] to 60.2 [36.9; 82.8], p = .0427) and remained unchanged in the glimepiride group.Improving metabolic control has beneficial effects in microvascular function in type 2 diabetic patients. Treatment of type 2 diabetic patients with pioglitazone exerts additional effects on endothelial function beyond metabolic control.

yearjournalcountryeditionlanguage
2005-10-07Microcirculation (New York, N.Y. : 1994)
10.1080/10739680500253402https://pubmed.ncbi.nlm.nih.gov/16207627