Post-Meal Glucose Peaks at Home Associate with Carotid Intima-Media Thickness in Type 2 Diabetes

Esposito, Katherine; Ciotola, Miryam; Carleo, Diego; Schisano, Bruno; Sardelli, Luigi; Tommaso, Domenico Di; Misso, L; Saccomanno, F.; Ceriello, Antonio; Giugliano, Dario

doi:10.1210/jc.2007-2000

Cited by 159 publications

(126 citation statements)

References 39 publications

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“…[13][14][15][16] This study was designed to evaluate the prevalence and correlates of female sexual function in a population of diabetic women. The Campanian Post-Prandial Hyperglycemia Study 20,21 provided the opportunity to evaluate FSD in the context of a large observational study of type 2 diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

Determinants of female sexual dysfunction in type 2 diabetes

et al. 2010

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Studies assessing sexual dysfunction in type 2 diabetic women are scanty. This study was designed to evaluate the prevalence and correlates of female sexual function in a quite large population of diabetic women. A total of 595 women with type 2 diabetes completed a questionnaire of self-report measures of sexual dysfunction and were analyzed in this study. Their age was 57.9 ± 6.9 (mean and s.d.), duration of diabetes was 5.2 ± 1.5 years and mean hemoglobin A1c (HbA1c) level was 8.3±1.3%. Female sexual dysfunction (FSD) was assessed by the Female Sexual Function Index instrument with a cut-off score of 23. The overall prevalence of FSD among the diabetic women was 53.4%, significantly higher in menopausal women (63.9%), as compared with nonmenopausal women (41.0%, Po0.001). There was no association between HbA1c, duration of diabetes, hypertension, or cigarette smoking status and FSD; on the contrary, age, metabolic syndrome and atherogenic dyslipidemia were significantly associated with FSD. Both depression and marital status were independent predictors of FSD, while physical activity was protective. Further studies are needed to elucidate in full the mechanisms underlying the evident differences between male and female sexual function. In the meantime, evaluation of female sexuality should become a routine evaluation in women with type 2 diabetes, such as other diabetic complications.

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Section: Introductionmentioning

confidence: 99%

Determinants of female sexual dysfunction in type 2 diabetes

et al. 2010

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“…The reasons for failure of the HbA 1c -based glycemic control strategies used in these more recent studies are not clear, but one possibility is that HbA 1c levels do not assess variability in plasma glucose levels; that is, HbA 1c does not directly reflect the frequency or severity of either hypoglycemic events or hyperglycemic increments after meals, both of which may cause physiologic changes that contribute to long-term risks. Possible mechanisms for such effects include systemic inflammation (8,9), oxidative stress (10), endothelial dysfunction (11,12), intimal-medial thickening (13), and cardiac ischemia or arrhythmias (14)(15)(16). Considerable literature linking various CVD risk markers with glycemic variability has been published (17,18).…”

mentioning

confidence: 99%

Design of FLAT-SUGAR: Randomized Trial of Prandial Insulin Versus Prandial GLP-1 Receptor Agonist Together With Basal Insulin and Metformin for High-Risk Type 2 Diabetes

Investigators¹,

Probstfield²,

Hirsch³

et al. 2015

Diabetes Care

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OBJECTIVEGlycemic variability may contribute to adverse medical outcomes of type 2 diabetes, but prior therapies have had limited success in controlling glycemic fluctuations, and the hypothesis has not been adequately tested. RESEARCH DESIGN AND METHODSPeople with insulin-requiring type 2 diabetes and high cardiovascular risk were enrolled during a run-in period on basal-bolus insulin (BBI), and 102 were randomized to continued BBI or to basal insulin with a prandial GLP-1 receptor agonist (GLIPULIN) group, each seeking to maintain HbA 1c levels between 6.7% and 7.3% (50-56 mmol/mol) for 6 months. The primary outcome measure was glycemic variability assessed by continuous glucose monitoring; other measures were HbA 1c , weight, circulating markers of inflammation and cardiovascular risk, albuminuria, and electrocardiographic patterns assessed by Holter monitoring. RESULTSAt randomization, the mean age of the population was 62 years, median duration of diabetes 15 years, mean BMI 34 kg/m 2 , and mean HbA 1c 7.9% (63 mmol/mol). Thirty-three percent had a prior cardiovascular event, 18% had microalbuminuria, and 3% had macroalbuminuria. At baseline, the continuous glucose monitoring coefficient of variation for glucose levels was similar in both groups. CONCLUSIONSFLAT-SUGAR is a proof-of-concept study testing whether, in a population of individuals with type 2 diabetes and high cardiovascular risk, the GLIPULIN regimen can limit glycemic variability more effectively than BBI, reduce levels of cardiovascular risk markers, and favorably alter albuminuria and electrocardiographic patterns. We successfully randomized a population that has sufficient power to answer the primary question, address several secondary ones, and complete the protocol as designed.

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“…This is disappointing because (1) there is a dearth of studies that have involved analyses of glucose variability, particularly in such populations as Mexican Americans residing in impoverished rural communities, (2) glucose variability has been associated with risk of microvascular complications and increased carotid intima media thickness, (3) increased glucose variability is a strong predictor of hypoglycemia and poor glucose control, and (4) wide variability and poor control can be masked by relying on A1C values to assess management status. [20][21][22][23] SMBG is not a ''stand-alone'' diabetes therapeutic intervention. It may be difficult for persons with T2DM to see its value when it is one of several behavioral strategies recommended for daily diabetes self-management.…”

Section: Discussionmentioning

confidence: 99%

Blood Glucose Self-Monitoring Patterns in Mexican Americans: Further Lessons from the Starr County Border Health Initiative

Cuevas

Brown

García

et al. 2015

Diabetes Technology & Therapeutics

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Background: The purpose was to describe patterns of home self-monitoring of blood glucose (SMBG) in Mexican Americans with type 2 diabetes mellitus enrolled in a diabetes self-management education protocol. Research questions were as follows: (1) What were the patterns and rates of home glucose self-monitoring over the 6-month course of the study? (2) What were the differences in monitoring rates between experimental and control groups? (3) What were the relationships between rates of monitoring and glycosylated hemoglobin (A1C), gender, and years with diabetes? Subjects and Methods: We used a randomized (by group) repeated-measures pretest/posttest control group design. Glucometer data from an experimental group (diabetes self-management education plus nurse case management) and a comparison group (diabetes self-management education only) were analyzed. Data were collected at baseline and at 3 and 6 months. Results: Overall average SMBG rates were low. Experimental and control group monitoring levels were not significantly different. More females than males never monitored glucose values, but more females than males checked at least one time per week. Those participants who checked their glucose levels more than once per week had diabetes for a longer period of time. Rates of monitoring were not strongly associated with A1C levels at 3 and 6 months, but at 6 months A1C levels were statistically significantly different based on whether or not individuals monitored their glucose levels (P = 0.03, n = 71). Conclusions: SMBG rates were low in this study despite SMBG education and access to free glucometers and test strips. The lower rates of SMBG may reflect the effects of unexpected environmental challenges, but exact causes remain unclear. Reasons for low rates of SMBG need to be explored further, especially in underserved communities.

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Post-Meal Glucose Peaks at Home Associate with Carotid Intima-Media Thickness in Type 2 Diabetes

Abstract: IGPs are frequent in the everyday life of patients with type 2 diabetes, occur for most (95%) within 1 h after meal, timing of IGPs is not influenced by treatment (diet or drugs), and IGPs correlate with CIMT.

Cited by 159 publications

References 39 publications

Determinants of female sexual dysfunction in type 2 diabetes

Determinants of female sexual dysfunction in type 2 diabetes

Design of FLAT-SUGAR: Randomized Trial of Prandial Insulin Versus Prandial GLP-1 Receptor Agonist Together With Basal Insulin and Metformin for High-Risk Type 2 Diabetes

Blood Glucose Self-Monitoring Patterns in Mexican Americans: Further Lessons from the Starr County Border Health Initiative

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