Diabetes Care. 2007 Apr 24; [Epub ahead of print]Telmisartan shows an
equivalent effect of vitamin C in further improving endothelial
dysfunction after glycemia normalization in type 1 diabetes.Ceriello
A, Piconi L, Esposito K, Giugliano D.
Centre of Exellence in Diabetes and Endocrinology, University Hospital
of Coventry and Warwickshire, Warwick Medical School, University of
Warwick, Coventry, U.K.
Background: Long-lasting hyperglycemia in type 1 diabetic patients
induces permanent alterations of endothelial function, by increased
oxidative stress, even when glycemia is normalized. Methods and
Results: In this study 36 type 1 diabetic patients and 12 controls
were enrolled. The diabetic patients were divided in three groups. The
first group was treated for 24h with insulin, achieving a near-
normalization of glycemia. At the 12 h of this treatment vitamin C was
added for the remaining 12h. The second group was treated for 24h with
vitamin C. At the 12 h of this treatment insulin was started,
achieving a near-normalization of glycemia for the remaining 12h. The
third group was treated for 24h with both vitamin C and insulin,
achieving near normalization of glycemia. The same protocols were run
after 1 month of Telmisartan or placebo. Neither normalization of
glycemia or vitamin C treatment alone was able to normalize
endothelial dysfunction or oxidative stress. Combining insulin and
vitamin C normalized endothelial dysfunction and decreased oxidative
stress to normal level. Telmisartan significantly improved basal
endothelial function and decreased nitrotyrosine plasma levels. In
patients treated with Telmisartan a near normalization of both flow
mediated vasodilation and oxidative stress was achieved when glycemia
was normalized, while adding vitamin C infusion did not show further
effect on endothelial function or nitrotyrosine plasma levels.
Conclusions: These data indicate that combining the normalization of
glycemia with an antioxidant can normalize endothelial function in
type 1 diabetic patients and that Telmisartan works as antioxidant as
vitamin C.
PMID: 17456844 [PubMed - as supplied by publisher]
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