The Library

Impact of acute hyperglycaemia on endothelial function and retinal vascular reactivity in patients with Type 2 diabetes

Tools

Chittari, Madhu Varma, McTernan, P. G. (Philip G.), Bawazeer, Nahla M., Constantinides, K., Ciotola, M., O'Hare, J. Paul, Kumar, Sudhesh and Ceriello, Antonio. (2011) Impact of acute hyperglycaemia on endothelial function and retinal vascular reactivity in patients with Type 2 diabetes. Diabetic Medicine, Volume 28 (Number 4). pp. 450-454. ISSN 0742-3071

Full text not available from this repository.

Official URL: http://dx.doi.org/10.1111/j.1464-5491.2010.03223.x

Abstract

In diabetes, endothelial dysfunction and an altered retinal blood flow have been reported and precede overt macrovascular and microvascular disease. Furthermore, an association between postprandial hyperglycaemia, retinopathy and cardiovascular disease has been observed.

Methods:

Endothelial function and retinal vascular reactivity have been measured in baseline conditions in 10 healthy control subjects and 21 patients with Type 2 diabetes. In the patients with Type 2 diabetes, endothelial function and retinal vascular reactivity have been also measured every hour, for 4 h, during an oral glucose tolerance test. Endothelial function has been evaluated by measuring flow-mediated vasodilation of the brachial artery, while retinal vascular reactivity has been measured using a retinal vessel analyser, during a flicker.

Results:

At 1 and 2 h after glucose ingestion, endothelial function decreased (P < 0.05), while retinal vascular reactivity increased, even at 3 h (P < 0.05), vs. the baseline values.

Conclusion :

Our data highlight that acute hyperglycaemia impacts on endothelial function simultaneously at both macrovascular and at microvascular levels, inducing functional change, which could contribute towards explaining the clinical evidence of a strong association between postprandial hyperglycaemia, cardiovascular disease and retinopathy.

Item Type:

Journal Article

Subjects:

R Medicine > RC Internal medicine

Divisions:

Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016)
Faculty of Medicine > Warwick Medical School

Library of Congress Subject Headings (LCSH):

Hyperglycemia -- Pathophysiology, Vascular endothelium, Non-insulin-dependent diabetes -- Treatment, Retina -- Blood-vessels

Journal or Publication Title:

Diabetic Medicine

Publisher:

Blackwell

ISSN:

0742-3071

Official Date:

April 2011

Dates:

Date	Event
April 2011	Published

Volume:

Volume 28

Number:

Number 4

Page Range:

pp. 450-454

Identification Number:

10.1111/j.1464-5491.2010.03223.x

Status:

Peer Reviewed

Publication Status:

Published

Access rights to Published version:

Restricted or Subscription Access

Funder:

BMI Fellowship

References:

1 Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 20-year
follow-up of intensive glucose control in Type 2 diabetes. N Engl J
Med 2008; 359: 1565–1576.
2 Simo´ R, Herna´ndez C. Advances in the medical treatment of
diabetic retinopathy. Diabetes Care 2009; 32: 1556–1562.
3 Xu J, Zou MH. Molecular insights and therapeutic targets for
diabetic endothelial dysfunction. Circulation 2009; 120: 1266–1286.
4 Pemp B, Schmetterer L. Ocular blood flow in diabetes and age-related
macular degeneration. Can J Ophthalmol 2008; 43: 295–301.
5 Grunwald JE, Riva CE, Petrig BL, Brucker AJ, Schwartz SS,
Braunstein SN et al. Strict control of glycaemia: effects on blood
flow in the large retinal vessels and in the macular microcirculation.
Br J Ophthalmol 1995; 79: 735–741.
6 Ceriello A. Cardiovascular effects of acute hyperglycaemia: pathophysiological
underpinnings. Diab Vasc Dis Res 2008; 5: 260–268.
7 Gilmore ED, Hudson C, Nrusimhadevara RK, Ridout R, Harvey
PT, Mandelcorn M et al. Retinal arteriolar hemodynamic response
to an acute hyperglycemic provocation in early and sight-threatening
diabetic retinopathy. Microvasc Res 2007; 73: 191–197.
8 Dorner GT, Garho¨ fer G, Huemer KH, Riva CE, Wolzt M,
Schmetterer L. Hyperglycemia affects flicker-induced vasodilation
in the retina of healthy subjects. Vision Res 2003; 43: 1495–1500.
9 Arlotte DV, Perrott RL, Drasdo N, Owens DR, North RV. The
effect of postprandial glucose changes on oscillatory potentials in
subjects with type 2 diabetes mellitus. Doc Ophthalmol 2004; 109:
35–42.
10 Drexler H, Hornig B. Endothelial dysfunction in human disease.
J Mol Cell Cardiol 1999; 31: 51–60.
11 Ceriello A, Taboga C, Tonutti L, Quagliaro L, Piconi L, Bais B et al.
Evidence for an independent and cumulative effect of postprandial
hypertriglyceridemia and hyperglycemia on endothelial dysfunction
and oxidative stress generation: effects of short- and long-term
simvastatin treatment. Circulation 2002; 106: 1211–1218.
12 Sidhu JS, Newey VR, Nassiri DK, Kaski J-C. A rapid and reproducible
online automated technique to determine endothelial function.
Heart 2002; 88: 289–292.
13 Nagel E, Vilser W. Flicker observation light induces diameter
response in retinal arterioles: a clinical methodological study. Br
J Ophthalmol 2004; 88: 54–56.
14 Seifert U, Vilser W. Retinal Vessel Analyzer (RVA) – Design and
Function. Biomed Tech (Berl) 2002; 47; Suppl 1 Pt 2: 678–681.
15 Gugleta K, Zawinka C, Rickenbacher I, Kochkorov A, Katamay R,
Flammer J et al. Analysis of retinal vasodilation after flicker light
stimulation in relation to vasospastic propensity. Invest Ophthalmol
Vis Sci 2006; 47: 4034–4041.
16 Nguyen TT, Kawasaki R, Wang JJ, Kreis AJ, Shaw J, Vilser W et al.
Flicker light-induced retinal vasodilation in diabetes and diabetic
retinopathy. Diabetes Care 2009; 32: 2075–2080.
17 Pemp B, Weigert G, Karl K, Petzl U, Wolzt M, Schmetterer L et al.
Correlation of flicker-induced and flow-mediated vasodilatation in
patients with endothelial dysfunction and healthy volunteers.
Diabetes Care 2009; 32: 1536–1541.
18 Wang JJ, Liew G, Wong TY, Smith W, Klein R, Leeder SR et al.
Retinal vascular calibre and the risk of coronary heart diseaserelated
death. Heart 2006; 92: 1583–1587.
19 Wang L, Wong TY, Sharrett AR, Klein R, Folsom AR, Jerosch-
Herold M. Relationship between retinal arteriolar narrowing and
myocardial perfusion: Multi-Ethnic Study of Atherosclerosis.
Hypertension 2008; 51: 119–126.
20 Ceriello A. Postprandial hyperglycemia and diabetic complications:
is it time to treat? Diabetes 2005; 54: 1–7.
21 Raz I, Wilson PW, Strojek K, Kowalska I, Bozikov V, Gitt AK et al.
Effects of prandial versus fasting glycemia on cardiovascular outcomes
in type 2 diabetes: the HEART2D trial. Diabetes Care 2009;
32: 381–386.
22 Ceriello A. Postprandial hyperglycemia and cardiovascular disease:
is the HEART2D study the answer? Diabetes Care 2009; 32: 521–
522.
23 Juutilainen A, Lehto S, Ro¨nnemaa T, Pyo¨ ra¨ la¨ K, Laakso M. Retinopathy
predicts cardiovascular mortality in type 2 diabetic men
and women. Diabetes Care 2007; 30: 292–299.
24 Shiraiwa T, Kaneto H, Miyatsuka T, Kato K, Yamamoto K,
Kawashima A et al. Postprandial hyperglycemia is a better predictor
of the progression of diabetic retinopathy than HbA1c in Japanese
type 2 diabetic patients. Diabetes Care 2005; 28: 2806–2807.
25 Meier JJ, Baller B, Menge BA, Gallwitz B, Schmidt WE, Nauck MA.
Excess glycaemic excursions after an oral glucose tolerance test
compared with a mixed meal challenge and self-measured home
glucose profiles: is the OGTT a valid predictor of postprandial
hyperglycaemia and vice versa? Diabetes Obes Metab 2009; 11:
213–222.