Ceriello, Antonio, Piconi, Ludovica, Esposito, Katherine and Giugliano, Dario (2007) Telmisartan shows an equivalent effect of vitamin C in further improving endothelial dysfunction after glycemia normalization in type 1 diabetes. Diabetes Care, Vol.30 (No.7). pp. 1694-1698. doi:10.2337/dc07-0318 ISSN 0149-5992.

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Abstract

OBJECTIVE - Long-lasting hyperglycemia in type I diabetic patients induces permanent alterations of endothelial function by increased oxidative stress, even when glycemia is normalized.

RESEARCH DESIGN AND METHODS - in this study, 36 type I diabetic patients and 12 control subjects were enrolled. The diabetic patients were divided into three groups. The first group was treated for 24 h with insulin, achieving a near normalization of glycemia. After 12 h of this treatment, vitamin C was added for the remaining 12 h. The second group was treated for 24 h with vitamin C. After 12 h of this treatment, insulin was started, achieving a near normalization of glycemia for the remaining 12 h. The third group was treated for 24 h with both vitamin C and insulin, achieving near normalization of glycemia. The same protocols were performed after I month of telmisartan or placebo.

RESULTS - Neither normalization of glycemia nor 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 levels. 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, whereas 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 I diabetic patients and that telmisartan works as an antioxidant like vitamin C.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title:	Diabetes Care
Publisher:	American Diabetes Association
ISSN:	0149-5992
Official Date:	July 2007
Dates:	Date Event July 2007 Published
Volume:	Vol.30
Number:	No.7
Number of Pages:	5
Page Range:	pp. 1694-1698
DOI:	10.2337/dc07-0318
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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