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

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background Multifactorial intervention is unable to improve endothelial dysfunction/cardiovascular outcome in type 2 diabetes. Intensive insulin therapy improves pancreatic β-cell dysfunction in patients with early stage diabetes. We investigated the effect of intensive insulin therapy on endothelial dysfunction in these patients.MethodsOne 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.ResultsCompared 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/l vs. 109.69 ± 6.30 U/l, P < 0.01; group B: 219.18 ± 6.92 U/l vs. 109.69 ± 6.30 U/l, 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/l vs. 224.34 ± 7.36 U/l, P = 0.49), but significantly decreased after intensive insulin therapy (155.08 ± 11.82 U/l vs. 219.18 ± 6.92 U/l, P = 0.0013).ConclusionsIntensive 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.

Original languageEnglish (US)
Pages (from-to)1242-1248
Number of pages7
JournalAmerican journal of hypertension
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2012

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Keywords

  • blood pressure
  • brachial artery flow-mediated dilation
  • early intensive insulin therapy
  • hypertension
  • type 2 diabetes
  • vascular endothelial dysfunction
  • von Willebrand factor

ASJC Scopus subject areas

  • Internal Medicine

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