OBJECTIVE -Impaired endothelial function of resistance and conduit arteries can be detected in patients with type 1 diabetes. We studied whether a persistent improvement of endothelial function can be achieved by regular physical training.RESEARCH DESIGN AND METHODS -The study included 26 patients with type 1 diabetes of 20 Ϯ 10 years' duration and no overt angiopathy; 18 patients (42 Ϯ 10 years old) participated in a bicycle exercise training program, and 8 patients with type 1 diabetes (33 Ϯ 11 years old) served as control subjects. Vascular function of conduit arteries was assessed by flow-mediated and endothelium-independent dilation of the brachial artery and of resistance vessels by the response of ocular fundus pulsation amplitudes to intravenous N G -monomethyl-L-arginine (L-NMMA) at baseline, after 2 and 4 months of training, and 8 months after cessation of regular exercise.RESULTS -Training increased peak oxygen uptake (VO 2max ) by 13% after 2 months and by 27% after 4 months (P ϭ 0.04). Flow-mediated dilation (FMD) of the brachial artery increased from 6.5 Ϯ 1.1 to 9.8 Ϯ 1.1% (P ϭ 0.04) by training. L-NMMA administration decreased fundus pulsation amplitude (FPA) by 9.1 Ϯ 0.9% before training and by 13.4 Ϯ 1.5% after 4 months of training (P ϭ 0.02). VO 2max , FMD, and FPA were unchanged in the control group. Vascular effects from training were abrogated 8 months after cessation of exercise.CONCLUSIONS -Our study demonstrates that aerobic exercise training can improve endothelial function in different vascular beds in patients with long-standing type 1 diabetes, who are at considerable risk for diabetic angiopathy. However, the beneficial effect on vascular function is not maintained in the absence of exercise.
Elevated visfatin concentrations in patients with T1DM can be lowered by regular physical exercise. It is unknown whether glucose tolerance is affected by changes in visfatin concentrations.
Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.
Elevated ADMA levels in patients with DM1, who have a high risk for developing cardiovascular disease, can be lowered to those of healthy persons by regular physical exercise. This favorable effect on ADMA is not sustained when training is discontinued.
Objective The aim of this study was to investigate the effect of alpha-lipoic acid (ALA) treatment on endothelium-dependent and -independent vasodilatation, assessed by forearm blood flow (FBF), in patients with type 2 diabetes mellitus.Research design and methods A total of 30 subjects with type 2 diabetes were included in this randomized, controlled, double-blinded, parallel group study. FBF responses to intra-arterial acetylcholine (ACh) and glycerol trinitrate (GTN) were measured before and after 21 days of intravenous treatment with 600 mg alpha-lipoic acid or placebo.Results FBF responses were comparable at baseline. After treatment, FBF reactivity to ACh and GTN was unchanged in subjects receiving placebo. By contrast, ALA treatment increased endothelium-dependent vasodilatation to ACh (P < 0AE05) but not to GTN compared with baseline.Conclusions Intravenous ALA treatment improves endothelium-dependent vasodilatation in patients with type 2 diabetes, in the absence of effects on forearm vasomotor function. If this salutary action translates into vascular risk reduction remains to be established.
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