Improving the Assessment of Flow-Mediated Dilation Through Detection of Peak Time in Healthy Subjects and Subjects With Type 2 Diabetes

Angiology ◽  
2020 ◽  
pp. 000331972098488
Author(s):  
Theresa Herbrand ◽  
Hans-Veit Coester ◽  
Roberto Sansone ◽  
Annelie Fischer ◽  
Christian Heiss ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sample Size ◽  
Healthy Subjects ◽  
Substantial Reduction ◽  
Intraindividual Variability ◽  
Peak Time ◽  
Flow Mediated Dilation ◽  
Fold Reduction ◽  
Precise Assessment

The assessment of flow-mediated dilation (FMD) is widely used to quantify endothelial function. Historically, FMD was determined at 60 seconds post-cuff deflation. We investigated whether FMD would be more accurate if determined at maximum dilatory peak (MDP) than at 60 seconds in healthy subjects and subjects with type 2 diabetes mellitus (T2DM). We studied 95 healthy and 72 subjects with T2DM and assessed FMD at MDP, 60 and 90 seconds. Twenty-four healthy and 12 subjects with T2DM underwent a repeat FMD after 28 days. In healthy subjects, FMD at MDP was higher than at 60 and 90 seconds, with mean difference MDP versus 60 seconds 1.14% (95% CI: 0.6-1.7); P < .0001 and MDP versus 90 seconds 1.9% (95% CI: 1.3-2.5) with similar results in T2DM, that is, 1.0% (95% CI: 0.1-1.9) and 2.3% (95% CI: 1.3-3.2), respectively. Intraindividual variability was lowest with MDP compared with 60 and 90 seconds, that is, 15.0 versus 23.2% and 40.0%, respectively, resulting in a more than 2-fold reduction in necessary sample size. In healthy subjects and subjects with T2DM, assessment of FMD using MDP results in a more accurate and precise assessment leading to a substantial reduction in sample size.

2216-PUB: More Precise Assessment of Flow-Mediated Dilation (FMD) by Measuring at Maximum Dilatory Peak Time (MDP) in Subjects With and Without Type 2 Diabetes (T2D)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2216-PUB
Author(s):  
THERESA HERBRAND ◽  
HANS VEIT COESTER ◽  
J. HANS DEVRIES ◽  
CHRISTIAN HEISS ◽  
TIM HEISE ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peak Time ◽  
Flow Mediated Dilation ◽  
Precise Assessment

P2429More precise assessment of flow-mediated dilation by measuring individually determined maximum dilatory peak time in healthy middle-aged subjects and patients with diabetes mellitus type 2

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Herbrand ◽  
H V Coester ◽  
H De Vries ◽  
C Heiss ◽  
T Heise ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Healthy Subjects ◽  
Diabetes Mellitus Type 2 ◽  
Least Square ◽  
Peak Time ◽  
Flow Mediated Dilation ◽  
Middle Aged ◽  
Time Points ◽  
Aged Subjects

Abstract The assessment of flow-mediated dilation (FMD) is widely used in clinical research to quantify endothelial function. FMD is calculated by subtracting the artery's baseline diameter from the peak diameter during hyperemia. However, there is no consensus on how to determine peak diameter. Many authors report FMD results based on values assessed at predefined time points. This may limit the accuracy and reproducibility of FMD. We hypothesised that FMD values using maximum dilatory peak time (MDP) would differ from those using predefined time points. Using individually determined MDP may lead to a lower number of subjects needed to show significance for a given difference in FMD. FMD was measured in middle-aged subjects with and without diabetes mellitus type 2 (T2DM) by ultrasound (12-MHz transducer). In a subset of subjects, FMD was measured again 30 days later. All measurements were performed by certified research physicians and evaluated using appropriate software. FMD values were compared at 60 s and 90 s after start of hyperaemia and at MDP during hyperaemia. FMD was measured in 100 healthy subjects and 72 subjects with T2DM (mean ± SD age 57±6 years, healthy: body mass index 26.2±3 kg/m2, blood pressure 127±10 /80±7 mmHg, DMT2: body mass index 29±3 kg/m2, blood pressure 135±11 / 86±5 mmHg, HbA1c 7.1±0.7%). FMD in healthy subjects was lower at predefined time points compared to MDP (least square mean difference (95% CI)) 60 s vs. MDP −1.14% (−1.72 to −0.56; p<0.0001) and 90 s vs. MDP −1.87% (−2.48 to −1.26; p<0.0001). Also in subjects with DMT2, FMD at predefined time points was lower compared to MDP (least square mean difference (95% CI)) 60 s vs. MDP −1.08% (−1.71 to −0.44; p<0.001) and 90 s vs. MDP −1.73% (−2.38 to −1.06; p<0.001). The intra-subject variability was lowest for MDP compared to 60 s and 90 s (15% vs. 36% and 51%, respectively). Assuming 80% power and alpha at 0.05, the individually determined peak requires 15 people to detect a 1% difference in FMD versus 26 subjects if determined at 60 s and 31 subjects if determined at 90 s. This study demonstrated significantly higher FMD values and superior reproducibility of the individually determined maximum dilatory peak compared to peaks at predefined time points in healthy middle-aged people and patients with type 2 diabetes. This roughly halves the number of study participants needed to detect a 1% difference in FMD.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Effects of telecare intervention on glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

2015 ◽  
Vol 172 (3) ◽  
pp. R93-R101 ◽  
Author(s):  
Zhenru Huang ◽  
Hong Tao ◽  
Qingdong Meng ◽  
Long Jing
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Randomized Controlled Trials ◽  
Sample Size ◽  
Plasma Glucose ◽  
Small Sample ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

ObjectiveTo review the published literature on the effects of telecare intervention in patients with type 2 diabetes and inadequate glycemic control.Design and methodsA review of randomized controlled trials on telecare intervention in patients with type 2 diabetes, and a search of electronic databases such as The Cochrane Library, PubMed, EBSCO, CINAHL, Science Direct, Journal of Telemedicine and Telecare, and China National Knowledge Infrastructure (CNKI), were conducted from December 8 to 16, 2013. Two evaluators independently selected and reviewed the eligible studies. Changes in HbA1c, fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), BMI, and body weight were analyzed.ResultsAn analysis of 18 studies with 3798 subjects revealed that telecare significantly improved the management of diabetes. Mean HbA1c values were reduced by −0.54 (95% CI, −0.75 to −0.34; P<0.05), mean FPG levels by −9.00 mg/dl (95% CI, −17.36 to −0.64; P=0.03), and mean PPG levels reduced by −52.86 mg/dl (95% CI, −77.13 to −28.58; P<0.05) when compared with the group receiving standard care. Meta-regression and subgroup analyses indicated that study location, sample size, and treatment-monitoring techniques were the sources of heterogeneity.ConclusionsPatients monitored by telecare showed significant improvement in glycemic control in type 2 diabetes when compared with those monitored by routine follow-up. Significant reduction in HbA1c levels was associated with Asian populations, small sample size, and telecare, and with those patients with baseline HbA1c greater than 8.0%.

scholarly journals Acute Endothelial Benefits of Fat Restriction over Carbohydrate Restriction in Type 2 Diabetes Mellitus: Beyond Carbs and Fats

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1859 ◽  
Author(s):  
Renate Barbosa-Yañez ◽  
Ulrike Dambeck ◽  
Linna Li ◽  
Jürgen Machann ◽  
Stefan Kabisch ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Endothelial Function ◽  
Body Fat ◽  
Protein Intake ◽  
Diet Group ◽  
Flow Mediated Dilation ◽  
Reduced Body ◽  
Diabetes Patients

Background: Cardiovascular diseases (CVD) are the major cause of mortality in type 2 diabetes patients (T2DM). The causes are embedded in a complex interplay between excess body fat, insulin resistance and serum lipid anomalies. Endothelial homeostasis is strongly affected by this pathogenic network. Even though metabolic changes and weight loss improve vascular endothelial function, the effect of different dietary approaches is still uncertain for type 2 diabetes patients. Objective: We aimed to compare the acute effects of a hypocaloric very low carbohydrate (VLC) diet versus a hypocaloric low fat (LF) diet on flow mediated dilation (FMD), intrahepatic lipid (IHL) accumulation and visceral adipose tissue as independent risk factors of CVD in T2DM patients. Design: 36 T2DM patients (age 63 ± 8 years, 60% females) were randomly assigned to the VLC diet (4–10% of total energy intake (E)) or to the LF diet (<30% E) for 3 weeks. Endothelial function was assessed by the flow mediated dilation (FMD) method. Adipose tissue depots and IHL were determined by magnetic resonance. Results: Both dietary strategies reduced body weight, body fat content and IHL. Unexpectedly, the LF group experienced significantly greater enhancement of FMD, compared to the VLC group. The FMD showed a positive correlation with protein intake and fat intake in the LF group, while it revealed a negative correlation with protein intake in the VLC diet group. Conclusions: Reduction of total and hepatic adiposity was shown to be successful using either the VLC or LF hypocaloric diets, however, improvements in FMD may be related to the interplay of fat and protein intake.

Subcutaneous glucagon-like peptide-1 (7-36) amide is insulinotropic and can cause hypoglycaemia in fasted healthy subjects

1998 ◽  
Vol 95 (6) ◽  
pp. 719-724 ◽  
Author(s):  
C. Mark B. EDWARDS ◽  
Jeannie F. TODD ◽  
Mohammad A. GHATEI ◽  
Stephen R. BLOOM
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Plasma Glucose ◽  
Healthy Subjects ◽  
Therapeutic Potential ◽  
Double Blind ◽  
Gut Hormone ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

1. Glucagon-like peptide-1 (7-36) amide (GLP-1) is a gut hormone released postprandially that stimulates insulin secretion, suppresses glucagon secretion and delays gastric emptying. The insulinotropic action of GLP-1 is more potent under hyperglycaemic conditions. Several published studies have indicated the therapeutic potential of subcutaneous GLP-1 in non-insulin-dependent (Type 2) diabetes mellitus. 2. We investigated whether subcutaneous GLP-1, at a dose shown to improve glycaemic control in early Type 2 diabetes, is insulinotropic at normal fasting glucose concentrations. A double-blind, randomized, crossover study of 10 healthy subjects injected with GLP-1 or saline subcutaneously after a 16 h fast was performed. The effect on cardiovascular parameters was also examined. 3. GLP-1 caused a near 5-fold rise in plasma insulin concentration. After treatment with GLP-1, circulating plasma glucose concentrations fell below the normal range in all subjects. One subject had symptoms of hypoglycaemia after GLP-1. A rise in pulse rate was found which correlated with the fall in plasma glucose concentration. An increase in blood pressure occurred with GLP-1 injection which was seen at the same time as the rise in plasma GLP-1 concentrations. 4. This study indicates that subcutaneous GLP-1 can override the normal homoeostatic mechanism maintaining fasting plasma glucose in man, and is also associated with an increase in blood pressure.

scholarly journals Evaluation of the effect of MTNR1B rs10830963 gene polymorphism on the therapeutic efficacy of nateglinide in treating type 2 diabetes among Chinese Han patients

2019 ◽  
Author(s):  
Jinfang Song ◽  
Mingzhu Zhang ◽  
Jiang Ni ◽  
Tao Wang ◽  
Yi-Qing Zhao
Keyword(s):  
Type 2 Diabetes ◽  
Gene Polymorphism ◽  
Therapeutic Efficacy ◽  
Healthy Subjects ◽  
Venous Blood ◽  
Melting Curve ◽  
Allelic Frequency ◽  
Model Assessment ◽  
Chinese Han

Abstract Background: Several studies have shown the association of polymorphisms in the MTNR1B gene with type 2 diabetes mellitus (T2DM). However, there is no evidence about the impacts of its genetic polymorphism on the therapeutic efficacy of nateglinide. Therefore, this prospective case-control study was designed to investigate the effect of MTNR1B rs10830963 gene polymorphism on the therapeutic efficacy of nateglinide in treating T2DM. Methods: We genotyped 200 healthy subjects using the method of the high resolution of melting curve (HRM). A total of 60 T2DM patients were enrolled and given nateglinide (360 mg/d) for 8 weeks orally who had the same genotypes CYP2C9*1 and SLCO1B1 521TT respectively. The outcome was measured by collecting the venous blood samples before and at the 8th week of the treatment. Also, anthropometric measurements, glucose, and lipid metabolism were determined before and after the nateglinide treatment. Results: It was found that the risk G allelic frequency of MTNR1B rs10830963 was higher in T2DM patients when compared with the healthy subjects (P<0.05). 60 newly diagnosed patients with type 2 diabetes after completing the eight weeks treatment came for the follow-up visit and showed a reduction in fasting plasma glucose (FPG) levels with an increase in homeostasis model assessment for β cell HOMA-β in the carriers of genotype CG + GG at rs10830963, when compared with the wild-type CC (P <0.05). Conclusion: Thus, it was found that the MTNR1B rs10830963 polymorphism was associated with the therapeutic efficacy of nateglinide in T2DM patients. Also, the CC homozygotes had a better effect than G allele carriers. Trial registration: This study was registered in the Chinese Clinical Trial Register (No. ChiCTR-CCC13003536).

A Study of Glycemic Response to Corinthian Raisins in Healthy Subjects and in Type 2 Diabetes Mellitus Patients

2013 ◽  
Vol 68 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Panagiotis T. Kanellos ◽  
Andriana C. Kaliora ◽  
Christos Liaskos ◽  
Nikolaos K. Tentolouris ◽  
Despina Perrea ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Healthy Subjects ◽  
Glycemic Response

Plasma glutaredoxin activity in healthy subjects and patients with abnormal glucose levels or overt type 2 diabetes

2013 ◽  
Vol 51 (2) ◽  
pp. 225-232 ◽  
Author(s):  
Yatao Du ◽  
Huihui Zhang ◽  
Sergio Montano ◽  
Jesper Hegestam ◽  
Neda Rajamand Ekberg ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Healthy Subjects ◽  
Glucose Levels

STUDY OF SERUM VITAMIN-D IN TYPE-2 DIABETES MELLITUS PATIENTS.

2021 ◽  
pp. 187-188
Author(s):  
Ajay Jain ◽  
Debina sarkar ◽  
G.G. Kaushik ◽  
Ankita Sharma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Blood Sugar ◽  
Healthy Subjects ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Type 2 Diabetic

Background: Type-2 diabetes mellitus (T2DM) is a progressive and chronic disease characterized by both β-cell dysfunction and increased insulin resistance. Diabetes mellitus is now considered a giant killer disease of the 21st century with its vicious prongs in the South-East Asian countries, specially India, which is rightly said to be the ''Diabetes Capital'' of the world. Vitamin D has important effects on insulin action, and may impact on a number of pathways which may be of importance in the development of type 2 diabetes mellitus. Materials & Methods: In this study 62 Type-2 diabetic patients, 62 healthy controls were enrolled. Biochemical analytes measured were Serum glucose (Fasting Blood Sugar & Post Prandial Blood Sugar), Glycosylated Haemoglobin, Serum Vitamin-D. Results: The mean Serum Vitamin-D in Type-2 diabetic subjects were (16.3 ±3.0) while in healthy subjects(controls) the values were (39.3±5.2) respectively. These values were found to be statistically highly signicant(p<0.001). Conclusion: Serum Vitamin-D levels were decreased in Type 2 diabetic subjects as compared to the values in healthy subjects(controls).

scholarly journals The Effect ofTinospora crispaon Serum Glucose and Insulin Levels in Patients with Type 2 Diabetes Mellitus

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Theerawut Klangjareonchai ◽  
Chulaporn Roongpisuthipong
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Healthy Subjects ◽  
Statistical Significance ◽  
Area Under The Curve ◽  
Serum Glucose ◽  
Dry Powder ◽  
Insulin Levels

Objective. To determine the effects ofTinospora crispaon serum glucose and insulin levels in healthy subjects and patients with type 2 diabetes mellitus.Method. Serum from 10 healthy subjects and 10 diabetic participants, who had fasted overnight, were obtained every 30–60 minutes during the 3 hours of continued fasting and during the 3 hours after ingestion of 75 g of glucose with or without ingestion of 125 or 250 g ofTinospora crispadry powder capsule. Glucose and Insulin levels were analyzed and the areas under the curve for mean serum glucose and insulin levels were calculated.Result. The areas under the curve of mean serum glucose and insulin levels in both healthy and diabetic participants were not significantly different between with or withoutTinospora crispadry powder capsule. In diabetic participants the area under the curve of glucose was slightly lesser when 250 mg ofTinospora crispawas ingested, but not reaching statistical significance (478 and 444 mg min/ml, resp.,P=0.57).Conclusion. The results suggest thatTinospora crispaingestion cannot affect serum glucose and insulin levels in healthy subjects or patients with type 2 diabetes mellitus.

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