Diabetes, Vol 45, Issue 9 1253-1258, Copyright © 1996 by American Diabetes Association

ARTICLES

Early atherosclerosis is retarded by improved long-term blood glucose control in patients with IDDM

KJ Jensen-Urstad, PG Reichard, JS Rosfors, LE Lindblad and MT Jensen-Urstad
Department of Clinical Physiology, Sodersjukhuset, Stockholm, Sweden.

Microangiopathy is retarded by improved blood glucose control in patients with IDDM. Whether or not this is true for macroangiopathy (atherosclerosis) has remained unclear. A total of 59 patients (44 +/- 1.5 years, previous HbA1C 9.4 +/- 0.2%, mean +/- SE) with IDDM were investigated. Of the 59 patients, 31 had been randomized to long-term intensified conventional insulin treatment (ICT), and the remaining 28 had received standard insulin treatment (ST). Blood glucose control was significantly better in the ICT patients with an HbAlc value (mean of 29 values during 10 years) of 7.1 +/- 0.1% compared with the ST patients' 8.2 +/- 0.2% (P < 0.0001). With high-frequency ultrasound, endothelial function was measured as flow-mediated dilation of the right brachial artery. The carotid arteries were scanned for plaques, intima-media thickness was measured, and arterial wall stiffness was calculated in the right common carotid artery. These measurements correlate with manifest and/or risk factors for coronary atherosclerosis. The patients in the ST group had stiffer arteries (P = 0.011) and thicker intima-media in the left common carotid artery (P = 0.009) than those in the ICT group. Patients with lower HbA1c generally had better endothelial function (P = 0.028) and less stiff arteries (P = 0.009). Better blood glucose control in patients with IDDM is related not only to less microangiopathy but also to a slower development of atherosclerosis.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				T. J. Orchard, T. Costacou, A. Kretowski, and R. W. Nesto Type 1 diabetes and coronary artery disease. Diabetes Care, November 1, 2006; 29(11): 2528 - 2538. [Full Text] [PDF]

				H. N. Hodis, W. J. Mack, L. Zheng, Y. Li, M. Torres, D. Sevilla, Y. Stewart, B. Hollen, K. Garcia, P. Alaupovic, et al. Effect of Peroxisome Proliferator-Activated Receptor {gamma} Agonist Treatment on Subclinical Atherosclerosis in Patients With Insulin-Requiring Type 2 Diabetes Diabetes Care, July 1, 2006; 29(7): 1545 - 1553. [Abstract] [Full Text] [PDF]

				A. Jawa, S. Nachimuthu, M. Pendergrass, S. Asnani, and V. Fonseca Impaired Vascular Reactivity in African-American Patients with Type 2 Diabetes Mellitus and Microalbuminuria or Proteinuria Despite Angiotensin-Converting Enzyme Inhibitor Therapy J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 31 - 35. [Abstract] [Full Text] [PDF]

				D. A. Stakos, D. P. Schuster, E. A. Sparks, C. F. Wooley, K. Osei, and H. Boudoulas Cardiovascular Effects of Type 1 Diabetes Mellitus in Children Angiology, May 1, 2005; 56(3): 311 - 317. [Abstract] [PDF]

				F. J. Quintana, P. H. Hagedorn, G. Elizur, Y. Merbl, E. Domany, and I. R. Cohen Functional immunomics: Microarray analysis of IgG autoantibody repertoires predicts the future response of mice to induced diabetes PNAS, October 5, 2004; 101(suppl_2): 14615 - 14621. [Abstract] [Full Text] [PDF]

				M. H. Tayebjee, H. S. Lim, R. J. MacFadyen, and G. Y.H. Lip Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 and -2 in Type 2 Diabetes: Effect of 1 year's cardiovascular risk reduction therapy Diabetes Care, August 1, 2004; 27(8): 2049 - 2051. [Full Text] [PDF]

				E. Barrett-Connor, E.-G. V. Giardina, A. K. Gitt, U. Gudat, H. O. Steinberg, and D. Tschoepe Women and Heart Disease: The Role of Diabetes and Hyperglycemia Arch Intern Med, May 10, 2004; 164(9): 934 - 942. [Abstract] [Full Text] [PDF]

				M. Bucci, F. Roviezzo, V. Brancaleone, M. I. Lin, A. Di Lorenzo, C. Cicala, A. Pinto, W. C. Sessa, S. Farneti, S. Fiorucci, et al. Diabetic Mouse Angiopathy Is Linked to Progressive Sympathetic Receptor Deletion Coupled to an Enhanced Caveolin-1 Expression Arterioscler. Thromb. Vasc. Biol., April 1, 2004; 24(4): 721 - 726. [Abstract] [Full Text] [PDF]

				V. Fonseca, C. Desouza, S. Asnani, and I. Jialal Nontraditional Risk Factors for Cardiovascular Disease in Diabetes Endocr. Rev., February 1, 2004; 25(1): 153 - 175. [Abstract] [Full Text] [PDF]

				The Diabetes Control and Complications Trial/Epide Intensive Diabetes Therapy and Carotid Intima-Media Thickness in Type 1 Diabetes Mellitus N. Engl. J. Med., June 5, 2003; 348(23): 2294 - 2303. [Abstract] [Full Text] [PDF]

				T. Nishikawa, T. Sasahara, S. Kiritoshi, K. Sonoda, T. Senokuchi, T. Matsuo, D. Kukidome, N. Wake, T. Matsumura, N. Miyamura, et al. Evaluation of Urinary 8-Hydroxydeoxy-Guanosine as a Novel Biomarker of Macrovascular Complications in Type 2 Diabetes Diabetes Care, May 1, 2003; 26(5): 1507 - 1512. [Abstract] [Full Text] [PDF]

				T. P. Singh, H. Groehn, and A. Kazmers Vascular function and carotid intimal-medial thickness in children with insulin-dependent diabetes mellitus J. Am. Coll. Cardiol., February 19, 2003; 41(4): 661 - 665. [Abstract] [Full Text] [PDF]

				J. Larsen, M. Brekke, L. Sandvik, H. Arnesen, K. F. Hanssen, and K. Dahl-Jorgensen Silent Coronary Atheromatosis in Type 1 Diabetic Patients and Its Relation to Long-Term Glycemic Control Diabetes, August 1, 2002; 51(8): 2637 - 2641. [Abstract] [Full Text] [PDF]

				R. S. Surwit, R. B. Williams, I. C. Siegler, J. D. Lane, M. Helms, K. L. Applegate, N. Zucker, M. N. Feinglos, C. M. McCaskill, and J. C. Barefoot Hostility, Race, and Glucose Metabolism in Nondiabetic Individuals Diabetes Care, May 1, 2002; 25(5): 835 - 839. [Abstract] [Full Text] [PDF]

				E. Suzuki, A. Kashiwagi, Y. Nishio, K. Egawa, S. Shimizu, H. Maegawa, M. Haneda, H. Yasuda, S. Morikawa, T. Inubushi, et al. Increased Arterial Wall Stiffness Limits Flow Volume in the Lower Extremities in Type 2 Diabetic Patients Diabetes Care, December 1, 2001; 24(12): 2107 - 2114. [Abstract] [Full Text] [PDF]

				D. Frost and W. Beischer Limited Joint Mobility in Type 1 Diabetic Patients: Associations with microangiopathy and subclinical macroangiopathy are different in men and women Diabetes Care, January 1, 2001; 24(1): 95 - 99. [Abstract] [Full Text]

				B. E. Eriksson, R. Tyni-Lenne, J. Svedenhag, R. Hallin, K. Jensen-Urstad, M. Jensen-Urstad, K. Bergman, and C. Sylven Physical training in Syndrome X: Physical training counteracts deconditioning and pain in Syndrome X J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1619 - 1625. [Abstract] [Full Text] [PDF]

				W. Liu, A. Schoenkerman, and W. L. Lowe Jr. Activation of members of the mitogen-activated protein kinase family by glucose in endothelial cells Am J Physiol Endocrinol Metab, October 1, 2000; 279(4): E782 - E790. [Abstract] [Full Text] [PDF]

				I.B. Wilkinson, H. MacCallum, D.F. Rooijmans, G.D. Murray, J.R. Cockcroft, J.A. McKnight, and D.J. Webb Increased augmentation index and systolic stress in type 1 diabetes mellitus QJM, July 1, 2000; 93(7): 441 - 448. [Abstract] [Full Text] [PDF]

				J. Westerbacka, A. Uosukainen, S. Makimattila, A. Schlenzka, and H. Yki-Jarvinen Insulin-Induced Decrease in Large Artery Stiffness Is Impaired in Uncomplicated Type 1 Diabetes Mellitus Hypertension, May 1, 2000; 35(5): 1043 - 1048. [Abstract] [Full Text] [PDF]

				K. L. Berry, R. A. P. Skyrme-Jones, J. D. Cameron, R. C. O'Brien, and I. T. Meredith Systemic arterial compliance is reduced in young patients with IDDM Am J Physiol Heart Circ Physiol, June 1, 1999; 276(6): H1839 - H1845. [Abstract] [Full Text] [PDF]

				S. Rosfors, S. Hallerstam, K. Jensen-Urstad, M. Zetterling, and C. Carlstrom Relationship Between Intima-Media Thickness in the Common Carotid Artery and Atherosclerosis in the Carotid Bifurcation Stroke, July 1, 1998; 29(7): 1378 - 1382. [Abstract] [Full Text] [PDF]