Endothelial Function in Patients With Newly Diagnosed Type 2 Diabetes Receiving Early Intensive Insulin Therapy

Jing Tian; Jingfeng Wang; Yan Li; Daniel Villarreal; Robert Carhart; Yanbin Dong; Yanling Wen; Kan Liu

doi:10.1038/ajh.2012.122

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Endothelial Function in Patients With Newly Diagnosed Type 2 Diabetes Receiving Early Intensive Insulin Therapy

Journal article

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Endothelial Function in Patients With Newly Diagnosed Type 2 Diabetes Receiving Early Intensive Insulin Therapy

Jing Tian, Jingfeng Wang, Yan Li, Daniel Villarreal, Robert Carhart, Yanbin Dong, Yanling Wen and Kan Liu

American journal of hypertension, Vol.25(12), pp.1242-1248

12/01/2012

DOI: 10.1038/ajh.2012.122

PMID: 22895449

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Abstract

BACKGROUND Multifactorial intervention is unable to improve endothelial dysfunction/cardiovascular outcome in type 2 diabetes. Intensive insulin therapy improves pancreatic beta-cell dysfunction in patients with early stage diabetes. We investigated the effect of intensive insulin therapy on endothelial dysfunction in these patients. METHODS One hundred and sixteen patients with newly diagnosed type 2 diabetes and 59 healthy subjects received flow-mediated dilatation (FMD) and von Willebrand factor (vWF) measurement. Diabetic patients were further treated with either multifactorial intervention (group A), or intensive insulin therapy (group B) for 2 weeks. Both FMD and vWF measurement were repeated at the same time. FMD was reassessed 90 days after intervention. RESULTS Compared with healthy subjects, FMD in diabetic patients was significantly lower (group A: 15.99 +/- 7.81 % vs. 25.17 +/- 7.12%, P < 0.01; group B: 16.85 +/- 7.30% vs. 25.17 +/- 7.12%, P < 0.01), plasma vWF was significantly higher (group A: 224.34 +/- 7.36 U/I vs. 109.69 +/- 6.30 U/I, P < 0.01; group B: 219.18 +/- 6.92 U/I vs. 109.69 +/- 6.30 U/I, P < 0.01). After treatment, there was no significant change of FMD in either group. The vWF did not change after multifactorial intervention (220.96 +/- 6.85 U/I vs. 224.34 +/- 7.36 U/I, P = 0.49), but significantly decreased after intensive insulin therapy (155.08 +/- 11.82 U/I vs. 219.18 +/- 6.92 U/I, P = 0.0013). CONCLUSIONS Intensive insulin therapy significantly improves endothelial injury/dysfunction as measured by vWF in early stage type 2 diabetes. Further study is needed to determine whether plasma vWF can help early identification, stratification and management of diabetic endothelial dysfunction.

Cardiovascular System & Cardiology

Life Sciences & Biomedicine

Peripheral Vascular Disease

Science & Technology

Details

Title: Subtitle: Endothelial Function in Patients With Newly Diagnosed Type 2 Diabetes Receiving Early Intensive Insulin Therapy
Creators: Jing Tian - Sun Yat-sen Memorial Hospital
Jingfeng Wang - Sun Yat-sen Memorial Hospital
Yan Li - Sun Yat-sen Memorial Hospital
Daniel Villarreal - SUNY Upstate Medical University
Robert Carhart - SUNY Upstate Medical University
Yanbin Dong - Augusta University
Yanling Wen - 4The 6th affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Kan Liu - SUNY Upstate Medical University
Resource Type: Journal article
Publication Details: American journal of hypertension, Vol.25(12), pp.1242-1248
DOI: 10.1038/ajh.2012.122
PMID: 22895449
NLM abbreviation: Am J Hypertens
ISSN: 0895-7061
eISSN: 1879-1905
Publisher: Oxford Univ Press
Number of pages: 7
Grant note: 2009B060700104 / Science & Technology Program of Guangdong Province 30973480 / National Natural Science Foundation of China; National Natural Science Foundation of China (NSFC)
Language: English
Date published: 12/01/2012
Academic Unit: Radiology; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984318808902771

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