Influence of Metabolic Control on Thromboxane Biosynthesis and Plasma Plasminogen Activator Inhibitor Type-1 in Non-insulin-dependent Diabetes mellitus

1996 ◽  
Vol 76 (01) ◽  
pp. 034-037 ◽  
Author(s):  
Giovanni Davì ◽  
Mario Belvedere ◽  
Sergio Vingneri ◽  
Isabella Catalano ◽  
Carlo Giammarresi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Control ◽  
Platelet Activation ◽  
Macrovascular Disease ◽  
Dependent Diabetes Mellitus ◽  
Secondary Failure ◽  
Diet And Exercise ◽  
Strict Diet ◽  
Niddm Patients ◽  
Pai 1

SummaryWe have previously shown that tight metabolic control by insulin therapy reduced thromboxane-dependent platelet activation in noninsulin-dependent diabetes mellitus (NIDDM) patients. The present study was undertaken to determine whether a similar effect could be obtained without switching diabetics in secondary failure to insulin treatment. For this purpose, we gave strict diet and exercise advise program and adjusted on a weekly basis the oral antidiabetic therapy (glipizide) that 26 patients with NIDDM had been given over the previous months.Basal measurements of urinary ll-dehydro-TXB2 and PAI-1 confirmed previous findings of enhanced levels of these parameters in NIDDM patients with macrovascular disease in comparison to age-and sex-matched controls. After 2-6 weeks, 16 patients achieved tight metabolic control associated with significant reduction of both thromboxane biosynthesis and PAI-1 levels; 10 patients remained in poor control and no significant decrease of both parameters was observed.We conclude that reduction of in-vivo platelet activation and PAI-1 antigen levels after metabolic improvement obtained by frequent reassessment of sulphonylurea therapy together with strict diet and exercise programs may have beneficial effects on the progression of diabetic micro- and macrovascular disease.

Plasminogen Activator Inhibitor Type-1 (PAI-1) Levels Are Decreased in NIDDM Patients treated with Insulin

1998 ◽  
Vol 4 (2) ◽  
pp. 138-139
Author(s):  
Peter Galajda ◽  
Emil Martinka ◽  
Ján Staško ◽  
Marian Mokáň ◽  
Peter Kubisz
Keyword(s):  
Diabetes Mellitus ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Insulin Dependent Diabetes Mellitus ◽  
Insulin Dependent Diabetes ◽  
Dependent Diabetes Mellitus ◽  
Insulin Dependent ◽  
Niddm Patients ◽  
Activator Inhibitor ◽  
Pai 1

We examined 25 non-insulin-dependent diabetes mellitus (NIDDM) patients treated with sulfonylurea (SU) regi mens, 14 NIDDM patients with 8-12 weeks long-acting insulin (INS) treatment and 15 age-matched normoinsulinemic healthy controls. Plasminogen activator inhibitor-1 (PAI-1) levels were significantly increased in NIDDM patients treated by SU agents (median 58.9, range 14-217 ng/ml) compared to patients with insulin therapy (median 20.7, 4-53 ng/ml) and normal controls (median 10.8, 4-52 ng/ml) (p < 0.001). Non-insulin- dependent diabetes mellitus subgroups were not different in other hemostatic (von Willebrand factor, thrombomodulin, tis sue factor pathway inhibitor, platelet factor-4 levels) and meta bolic (C-peptide, triglycerides) parameters and PAI-1 levels did not correlate with these hemostatic and metabolic parameters. This finding suggests that insulin application itself may cause decreased PAI-1 levels, probably by influence on intracellular calcium. This hypothesis requires further research. Key Words: PAI-1—Insulin treatment—Non—insulin—dependent diabetes mellitus.

Blood Pressure Response to Physical Exercise in Healthy Adolescents and Adolescents with Insulin-Dependent Diabetes Mellitus

1994 ◽  
Vol 86 (4) ◽  
pp. 425-432 ◽  
Author(s):  
H. Nordgren ◽  
U. Freyschuss ◽  
B. Persson
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Body Weight ◽  
Metabolic Control ◽  
Blood Pressure Response ◽  
Insulin Dependent Diabetes Mellitus ◽  
Pressure Response ◽  
Pressure Increase ◽  
Dependent Diabetes Mellitus ◽  
Insulin Dependent

1. Reference values for systolic blood pressure during exercise are provided for 88 healthy adolescents (12–22 years of age) of both sexes. Data were related to oxygen uptake, heart rate, blood lactate concentration, rate of perceived exertion, age, sex, body size and physcial fitness. 2. The same variables were measured in 55 adolescents of both sexes with insulin-dependent diabetes mellitus of about 12 years duration and were analysed with respect to the healthy control group, to degree of metabolic control and to late diabetic complications. 3. In healthy adolescents the pressure response was not related to sex or age. When compared with control subjects diabetic patients had a higher diastolic blood pressure at rest and a more marked blood pressure increase, 23 versus 19 mmHg W−1 kg−1 body weight, during exercise with no sex difference. The blood pressure rise was not related to metabolic control, glomerular hyperfiltration or physical fitness. 4. Prolonged exercise tests were no more informative regarding the blood pressure response to exercise than the stepwise increased load test. Analysing the blood pressure increase versus relative work load (W/kg body weight) during exercise reveals blood pressure differences otherwise not noted. A diabetic patient with blood pressure above the 97.5% confidence limit during exercise seems to have a higher risk of developing incipient nephropathy 5 years later.

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