Benfotiamine Counteracts Smoking-Induced Vascular Dysfunction in Healthy Smokers

Background. Smoking induces endothelial dysfunction (ED) mainly by exacerbating oxidative stress (OS) and inflammation. Benfotiamine, a thiamine prodrug with high bioavailability, prevents nicotine-induced vascular dysfunction in rats. It remained unknown whether this effect also occurs in humans. Methods. Therefore, 20 healthy volunteers (mean age: 38 years) were investigated twice, 7–10 days apart in a randomized, cross-over, and investigator-blinded design. Vascular function was assessed by flow-mediated vasodilatation (FMD) of the brachial artery and by measurements of the soluble vascular cell adhesion molecule (sVCAM)-1. Investigations were performed after an overnight fast as well as 20 minutes after one cigarette smoking. On another day, the same procedure was applied following a 3-day oral therapy with benfotiamine (1050 mg/day). Ten patients were randomized to start with smoking alone, and ten started with benfotiamine. Results. Results are expressed as (mean ± SEM). Smoking acutely induced a decrease in FMD by 50% (∗∗P<0.001 versus baseline) an effect significantly reduced by benfotiamine treatment to 25%∗§ (∗P<0.05 versus baseline, §P<0.05 versus smoking alone). Smoking-induced elevation in sVCAM-1 was also prevented by benfotiamine. The endothelium-independent vasodilatation remained unaltered between days. Conclusion. In healthy volunteers, smoking blunts vascular function mirrored by a decrease in FMD and an increase in sVCAM-1. Short-term treatment with benfotiamine significantly reduces these effects, showing protective vascular properties

Habitual dietary intake in response to futsal-based exercise in people with type 1 diabetes

Background: Adequate and appropriate nutrition in type 1 diabetic athletes is essential not only to increase the physical performance but also to prevent the hypoglycemic events. Detailed nutrition history represents the initial step in developing a proper meal plan according to the specific characteristics of the physical activity performed. Purpose: This study assessed changes in habitual dietary intake and macronutrient distribution in response to intermittent-type futsal-based exercise under free-living conditions in people with type 1 diabetes who have not previously received structured nutritional diabetes education. Methods: Nine people with type 1 diabetes (HbA1c 7.6±0.9%; Age 28±5 years; BMI 23.7±1.8 kg/m2; Diabetes duration 11.3±6.4 years) completed a 24-hour weighed food diary on two separate occasions: 1) on a day containing exercise (EX), and 2) a non-exercise day (CON). The exercise day consisted of performing a standardized 80-minute intermittent-type typical futsal-based training session. All participants were competing at an international-level in futsal. Participants had not previously received dietary education as part of their diabetes care. Food frequency and dietary intake were subsequently analyzed. Results: EX resulted in 78% of participants experiencing hypoglycemia, whereas this was limited to 45% under CON. Meal frequency and meal-time energy intake was similar between conditions (P≥0.050), however all participants under EX consumed additional carbohydrate-based snacks, whereas this was limited to 56% under CON. Correspondingly, total kcal intake was on average 31% greater under EX (EX 2470±783 vs. CON 1888±601 kcal.day−1; P=0.047), with more carbohydrate (EX 287.7±81.5 vs. CON 238.4±92.6 g.day−1; P=0.044), fat (EX 94.6±50.3 vs. CON 60.9±22.0 g.day−1; P=0.013), and protein (EX 128.2±68.2g vs. CON 99.2±44.2 g.day−1; P=0.039) consumed. Discussion: This is the first investigation to show that people with type 1 diabetes with no prior structured nutritional diabetes education performing intermittent-type futsal-based exercise rely predominantly on carbohydrate-based snacks to prevent exercise-induced hypoglycemia rather than adjust meal frequency, meal-macronutrient distribution, or meal-macronutrient amount

Habitual dietary intake in response to futsal-based exercise in people with type 1 diabetes

Background: Adequate and appropriate nutrition in type 1 diabetic athletes is essential not only to increase the physical performance but also to prevent the hypoglycemic events. Detailed nutrition history represents the initial step in developing a proper meal plan according to the specific characteristics of the physical activity performed. Purpose: This study assessed changes in habitual dietary intake and macronutrient distribution in response to intermittent-type futsal-based exercise under free-living conditions in people with type 1 diabetes who have not previously received structured nutritional diabetes education. Methods: Nine people with type 1 diabetes (HbA1c 7.6±0.9%; Age 28±5 years; BMI 23.7±1.8 kg/m2; Diabetes duration 11.3±6.4 years) completed a 24-hour weighed food diary on two separate occasions: 1) on a day containing exercise (EX), and 2) a non-exercise day (CON). The exercise day consisted of performing a standardized 80-minute intermittent-type typical futsal-based training session. All participants were competing at an international-level in futsal. Participants had not previously received dietary education as part of their diabetes care. Food frequency and dietary intake were subsequently analyzed. Results: EX resulted in 78% of participants experiencing hypoglycemia, whereas this was limited to 45% under CON. Meal frequency and meal-time energy intake was similar between conditions (P≥0.050), however all participants under EX consumed additional carbohydrate-based snacks, whereas this was limited to 56% under CON. Correspondingly, total kcal intake was on average 31% greater under EX (EX 2470±783 vs. CON 1888±601 kcal.day−1; P=0.047), with more carbohydrate (EX 287.7±81.5 vs. CON 238.4±92.6 g.day−1; P=0.044), fat (EX 94.6±50.3 vs. CON 60.9±22.0 g.day−1; P=0.013), and protein (EX 128.2±68.2g vs. CON 99.2±44.2 g.day−1; P=0.039) consumed. Discussion: This is the first investigation to show that people with type 1 diabetes with no prior structured nutritional diabetes education performing intermittent-type futsal-based exercise rely predominantly on carbohydrate-based snacks to prevent exercise-induced hypoglycemia rather than adjust meal frequency, meal-macronutrient distribution, or meal-macronutrient amount

Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo