scholarly journals Glycemic control prevents microvascular remodeling and increased tone in Type 2 diabetes: link to endothelin-1

2009 ◽  
Vol 296 (4) ◽  
pp. R952-R959 ◽  
Author(s):  
Kamakshi Sachidanandam ◽  
Jim R. Hutchinson ◽  
Mostafa M. Elgebaly ◽  
Erin M. Mezzetti ◽  
Anne M. Dorrance ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Receptor Expression ◽  
Myogenic Tone ◽  
Resistance Arteries ◽  
Gk Rats ◽  
Endothelin 1 ◽  
Vascular Compliance

Medial thickening and vascular hypertrophy of resistance arteries can lead to cardiovascular complications associated with diabetes. While previous studies have established a role of Type 1 diabetes in vascular remodeling, we recently extended these observations to Type 2 diabetes and reported increased collagen deposition due to alterations in matrix metalloproteinase expression and activity in mesenteric resistance arteries. These studies also showed that remodeling response was mediated by endothelin-1 (ET-1) via activation of ETA receptors, whereas blockade of ETB receptors exacerbated the remodeling. However, the effectiveness of glycemic control strategies in preventing these vascular changes, including activation of the ET system still remained unclear. Also, very little is known about whether and to what extent reorganization of the extracellular matrix (ECM) affects vascular compliance and vasomotor tone. Accordingly, this study assessed structural remodeling of mesenteric microvessels, vascular compliance, and myogenic tone, as well as the role of matrix metalloproteinases (MMP) in mediating these processes. Spontaneously diabetic, non-obese Goto-Kakizaki (GK) rats, a model for Type 2 diabetes, and normoglycemic Wistar rats were used for the studies. A subset of GK rats were administered metformin to achieve euglycemia. Glycemic control normalized the increased media-to-lumen ratios (M/L) and myogenic tone seen in diabetes, as well as normalizing plasma ET-1 levels and mesenteric ETA receptor expression. There was increased collagen synthesis in diabetes paralleled by decreased collagenase MMP-13 activity, while glycemic control attenuated the process. These findings and our previous study taken together suggest that hyperglycemia-mediated activation of ET-1 and ETA receptors alter vascular structure and mechanics in Type 2 diabetes.

Abstract TP436: Dysfunctional Cerebral Neovascularization And Remodeling Patterns In Obese And Lean Models Of Type 2 Diabetes

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Roshini Prakash ◽  
Maribeth Johnson ◽  
Susan C Fagan ◽  
Adviye Ergul
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Structural Characteristics ◽  
Structural Parameters ◽  
Volume Density ◽  
3 Dimensional ◽  
Gk Rats ◽  
Dimensional Reconstruction ◽  
Branch Density

We previously reported intense pial cerebral collateralization and arteriogenesis in a mild and lean model of type 2 diabetes, Goto-Kakizaki (GK) rats. Further 3-dimensional fluroscein (FITC) imaging studies revealed regional differences in increased cerebral neovascularization which was associated with poor vessel wall maturity. Building upon these findings, the goals of this study were a) to compare and contrast this pathological neovascularization pattern in db/db mice and GK models of diabetes, and b) determine the effect of glycemic control on erratic cerebral neovascularization. Total vascular volume, density and surface area as well as structural parameters including microvessel/macrovessel ratio, non-FITC perfusing vessel abundance, penetrating arteriole (PA) branching density and diameter, and tortuosity were measured by 3 dimensional reconstruction of FITC stained vasculature using Z-stacked images obtained with confocal microscopy. Lean GK rats exhibited an increase in both micro and macrovessel density, non-perfusing vessel abundance, branch density, diameter and tortuosity. Glycemic control with metformin prevented these changes. Obese db/db mice, on the other hand, showed an increase in only microvascular density but this was not associated with an increase in non-FITC perfusing vessels. PA branch density was higher than controls but branch diameter was reduced. Diabetes also promoted astrogliosis. These results suggests that type 2 diabetes leads to cerebral neovascularization and remodeling but structural characteristics of newly formed vessels differ between lean and obese models that have mild or severe hyperglycemia, respectively. The prevention of dysfunctional cerebral neovascularization by early glucose control suggests that hyperglycemia is a mediator of this response. N=4-8 * p≤ 0.05, ** p≤ 0.005 *** 0.0005

The role of illness schemata in self-care behaviors and glycemic control among patients with type 2 diabetes in Iran

2019 ◽  
Vol 13 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Taiga Shibayama ◽  
Somayeh Tanha ◽  
Yoshiki Abe ◽  
Hiromi Haginoya ◽  
Asadollah Rajab ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Self Care

scholarly journals Role of Sodium-Glucose Cotransporter 2 (SGLT 2) Inhibitors in the Treatment of Type 2 Diabetes

2011 ◽  
Vol 32 (4) ◽  
pp. 515-531 ◽  
Author(s):  
Muhammad A. Abdul-Ghani ◽  
Luke Norton ◽  
Ralph A. DeFronzo
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Tight Glycemic Control ◽  
Β Cell ◽  
Oral Antidiabetic Agents ◽  
Oral Antidiabetic ◽  
Sodium Glucose Cotransporter

Hyperglycemia plays an important role in the pathogenesis of type 2 diabetes mellitus, i.e., glucotoxicity, and it also is the major risk factor for microvascular complications. Thus, effective glycemic control will not only reduce the incidence of microvascular complications but also correct some of the metabolic abnormalities that contribute to the progression of the disease. Achieving durable tight glycemic control is challenging because of progressive β-cell failure and is hampered by increased frequency of side effects, e.g., hypoglycemia and weight gain. Most recently, inhibitors of the renal sodium-glucose cotransporter have been developed to produce glucosuria and reduce the plasma glucose concentration. These oral antidiabetic agents have the potential to improve glycemic control while avoiding hypoglycemia, to correct the glucotoxicity, and to promote weight loss. In this review, we will summarize the available data concerning the mechanism of action, efficacy, and safety of this novel antidiabetic therapeutic approach.

scholarly journals The Role of Aerobic Training Variables Progression on Glycemic Control of Patients with Type 2 Diabetes: a Systematic Review with Meta-analysis

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Rodrigo Sudatti Delevatti ◽  
Cláudia Gomes Bracht ◽  
Salime Donida Chedid Lisboa ◽  
Rochelle Rocha Costa ◽  
Elisa Corrêa Marson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Aerobic Training ◽  
Meta Analysis

scholarly journals Glycemic control among Latinos with type 2 diabetes: The role of social-environmental support resources.

2011 ◽  
Vol 30 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Addie L. Fortmann ◽  
Linda C. Gallo ◽  
Athena Philis-Tsimikas
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Environmental Support ◽  
Support Resources ◽  
Social Environmental

scholarly journals Indian consensus on durability of glycemic control in type 2 diabetes management and role of oral antidiabetic drugs

2021 ◽  
Vol 9 (12) ◽  
pp. 3745
Author(s):  
Manoj Chawla ◽  
Pramila Kalra ◽  
A. K. Khanna ◽  
Sisir Kumar Mahapatro
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Combination Therapy ◽  
Diabetes Management ◽  
Antidiabetic Drugs ◽  
Oral Antidiabetic Drugs ◽  
Related Factors ◽  
Oral Antidiabetic

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in an alarming way in India as well as across the globe. In order to minimize complications, there is a need to maintain good glycemic control in patients with T2DM and long-term durable glycemic control remains a challenge. Clinically, this challenge was addressed by step-wise intensification of therapy with additional antidiabetic drugs to maintain glycemic control. Various disease and patient-related factors as well as different antidiabetic agents influenced the durability of glycemic control differently. While understanding of the factors that influenced therapeutic outcomes had evolved, there was paucity of information about the durability of glycemic control and the role of oral antidiabetic drugs (OADs) in achieving it. With an objective to understand the role of durability of glycemic response in the management of Indian patients with T2DM, 4 advisory board meetings attended by 48 physicians from across the country were conducted in Mumbai, Delhi, Kolkata and Bengaluru. There was consensus to consider durability of glycemic control as an important goal in the management of T2DM. Personalized approach in T2DM management along with early initiation of dual combination therapy were recommended to achieve durability. Age group of patients, body mass index, glycated hemoglobin levels at diagnosis, presence or absence of comorbidities and complications are important factors that need to be considered before initiating dual combination therapy for patients with T2DM.

Carotid Atherosclerosis in Type 2 Diabetes Mellitus: Potential Role of Endothelin-1, Lipoperoxides, and Prostacyclin

Angiology ◽  
2002 ◽  
Vol 53 (3) ◽  
pp. 279-285 ◽  
Author(s):  
K. Kalogeropoulou ◽  
G. Mortzos ◽  
I. Migdalis ◽  
C. Velentzas ◽  
D.P. Mikhailidis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Potential Role ◽  
Carotid Atherosclerosis ◽  
Endothelin 1
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