EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)
Endothelial function and arterial stiffness indices remain unchanged following intensification of glycemic control in poorly controlled patients with long-standing type 2 diabetes mellitus
Sofia Antoniou 1 , Katerina K Naka 2 , Aris Bechlioulis 2 , Dimitrios Makriyiannis 3 , Marios Papadakis 4 , Agathocles Tsatsoulis 1 , Lampros K Michalis 2 & Stelios Tigas 1
1Department of Endocrinology, University Hospital of Ioannina, Ioannina, Greece; 22nd Department of Cardiology and Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece; 3Department of Medicine, Hatzikosta General Hospital, Ioannina, Greece; 4Department of Surgery, Helios Clinic, University Hospital Witten-Herdecke, Germany.
Objective: Clinical trials aiming at strict glycemic control in high-risk patients with type 2 diabetes (T2DM) failed to show reduction in the incidence of cardiovascular events. The exact mechanisms remain unclear. We aimed to investigate the effect of intensive antidiabetic therapy on vascular indices of T2DM patients.
Methods: We studied 62 T2DM patients [mean age 64 years, 52% males, mean T2DM duration 14 years) with poor glycemic control (HbA1c ≥7.5%), at baseline and a median of 9 months after intensive treatment to achieve optimal glycemic control according to current guidelines. Brachial artery flow-mediated dilation (FMD), pulse wave velocity (cfPWV), augmentation index (Aix), large (C1) and small artery elasticity (C2), carotid intima-media thickness (cIMT) and ankle-brachial index (ABI), were assessed.
Results: Improvement of HbA1c >0.5% was achieved in 81% of patients, while mean HbA1c decreased from 9.4 (1.8)% to 7.3 (1.1)%, P<0.001. Triglycerides decreased from 169 (132) to 135(70) mg/dl and cIMT increased (from 0.97 (0.25) to 1.03 (0.27) mm (both P< 0.05). No other significant changes were found. Interestingly, cIMT remained unchanged in those with <5 years duration, while it was increased among patients with longer disease duration (P<0.05).
Conclusions: In T2DM, aggressive glycemic control (mostly achieved with insulin treatment) was not associated with improvement in vascular indices at follow-up. Attenuation of cIMT was observed for those with short disease duration. The effect of optimal glycemic control on vascular indices at an earlier disease stage, with newer antidiabetic agents and/or over a more prolonged time period, requires further study.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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