17 research outputs found
Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients
WST臉P. Celem badania by艂a ocena wp艂ywu przewlek艂ego doustnego stosowania L-argininy, dzia艂aj膮cej przez normalizacj臋 szlaku NO/cykliczny 3’,5’-guanozyno monofosforan (cGMP), na popraw臋 insulinowra偶liwo艣ci obwodowej i w膮trobowej u 12 szczup艂ych os贸b chorych na cukrzyc臋 typu 2.
MATERIA艁 I METODY. Badanie, przeprowadzone metod膮 podw贸jnie 艣lepej pr贸by, trwa艂o 3 miesi膮ce. W pierwszym miesi膮cu chorych leczono typow膮 diet膮 cukrzycow膮. Nast臋pnie losowo przydzielono ich do dw贸ch grup. W grupie 1 przez 2 miesi膮ce stosowano
typow膮 diet臋 i placebo (doustnie 3 脳 d.). W grupie 2 pacjent贸w leczono przez miesi膮c diet膮 i placebo (doustnie 3 脳 d.) i nast臋pnie przez miesi膮c diet膮 i L-arginin膮 (3 g 3 脳 d.). Po pierwszymi i drugim miesi膮cu wykonano badanie za pomoc膮 klamry euglikemiczno-hiperinsulinemicznej z jednoczesnym
wlewem do偶ylnym znakowanej izotopowo glukozy (glukoza 6,6- 2H2). Grup膮 kontroln膮 stanowi艂o 10 zdrowych os贸b, u kt贸rych r贸wnie偶 wykonano badanie za pomoc膮 klamry.
WYNIKI. W grupie 1 w czasie badania nie zaobserwowano zmian podstawowego st臋偶enia cGMP, skurczowego ci艣nienia t臋tniczego, przep艂ywu krwi w przedramieniu, wykorzystania glukozy i endogennej produkcji glukozy. W grupie 2 przyjmowanie L-argininy spowodowa艂o normalizacj臋 podstawowego st臋偶enia cGMP, popraw臋 przep艂ywu w przedramieniu o 36%, oraz wykorzystania glukozy w badaniu metod膮 klamry metabolicznej o 34%, jak r贸wnie偶 obni偶enie skurczowego ci艣nienia t臋tniczego i endogennej produkcji glukozy odpowiednio o 14 i 29%. Pomimo tego w por贸wnaniu z grup膮 kontroln膮 podawanie L-argininy nie normalizuje ca艂kowicie metabolizmu glukozy.
WNIOSKI. Podawanie L-argininy u chorych na cukrzyc臋 typu 2 znacznie poprawia insulinowra偶liwo艣膰 obwodow膮 i w膮trobow膮, lecz nie normalizuje jej ca艂kowicie.INTRODUCTION. The aim of this study was to evaluate
whether long-term administration of L-arginine
acting through a normalization of NO/cyclic-guanosine-
3’,5’-cyclic monophosphate (cGMP) pathway
was able to ameliorate peripheral and hepatic insulin sensitivity in 12 lean type 2 diabetic patients.
MATERIAL AND METHODS. A double-blind study was
performed for 3 months. In the first month, patients
were treated with their usual diet. Then they were
randomly allocated into two groups. In group 1, patients
were treated with diet plus placebo (orally
three times per day) for 2 months. In group 2 patients
were treated for 1 month with diet plus placebo
(orally, three times per day) and then for 1
month with diet plus L-arginine (3 g three times per
day). At the end of the first and the second month
of therapy, patients underwent a euglycemic-hyperinsulinemic
clamp combined with [6,6-2H2] glucose
infusion. A total of 10 normal subjects underwent
the same test as control subjects.
RESULTS. In group 1, no changes in basal cGMP levels,
systolic blood pressure, forearm blood flow,
glucose disposal, and endogenous glucose production
were observed throughout. In group 2, L-arginine
normalized basal cGMP levels and significantly
increased forearm blood flow by 36% and glucose
disposal during the clamp by 34%, whereas it decreased
systolic blood pressure, and endogenous
glucose production by 14 and 29%, respectively. However,
compared with normal subjects, L-arginine
treatment was not able to completely overcome the
defect in glucose disposal.
CONCLUSIONS. L-arginine treatment significantly improves
but does not completely normalize peripheral
and hepatic insulin sensitivity in type 2 diabetic
patients
Metabolic and endothelial effects of trimetazidine on forearm skeletal muscle in patients with type 2 diabetes and ischemic cardiomyopathy
Endothelial nitric oxide synthase polymorphisms are associated with type 2 diabetes and the insulin resistance syndrome
Endothelial nitric oxide synthase (eNOS) variants were previously demonstrated in cardiovascular disease. To evaluate whether eNOS gene variants are associated with insulin resistance and type 2 diabetes, we evaluated polymorphisms in Exon7 (E298D), intron 18 (IVS18 + 27A-->C), and intron 23 (IVS23 + 10G-->T) in 159 type 2 diabetic patients without macrovascular complications and in 207 healthy control subjects. Samples for all hormonal and metabolic variables were obtained after an overnight fast. The D298 and IVS18 + 27C alleles, but not the IVS23 + 10G-->T variant, were significantly more frequent in type 2 diabetic patients than in control subjects. The two- and three-loci haplotype analysis showed that there is a statistically significant association between the eNOS variants and type 2 diabetes. No significant differences were observed in the clinical characteristics of type 2 diabetic patients according to genotypes (except for visceral obesity [waist-to-hip ratio], which was significantly more present in D298 homozygotes). Healthy control subjects homozygous for both D298 and IVS18 + 27C presented higher insulin, C-peptide, and nitric oxide levels, as well as higher HOMA (homeostasis model assessment) values than the double wild-type homozygotes, with values superimposable on those found in type 2 diabetic patients. In conclusion, we described a significant association between eNOS gene polymorphisms and type 2 diabetes, suggesting a new genetic susceptibility factor for hyperinsulinemia, insulin resistance, and type 2 diabetes
Triglycerides impair postischemic recovery in isolated hearts: roles of endothelin-1 and trimetazidine
Metabolic instability in type I diabetic patients. Studies on insulin absorption, hepatic production of metabolites and glucose counterregulation
Effect of normalization of fasting glucose by intensified insulin therapy and influence of eNOS polymorphisms on the incidence of restenosis after peripheral angioplasty in patients with type 2 diabetes: A randomized, open-label clinical trial
Primary objective was to evaluate whether an intensified insulin therapy (IIT) incorporating the target of normal fasting glucose and HbA1c levels could halve the incidence of restenosis/amputation/SCA/death at 6 months after peripheral angioplasty compared with standard care (SC) in patients with type 2 diabetes (DMT2) affected by critical limb ischemia (CLI). Forty-six consecutive patients with DMT2 and CLI were randomly assigned to a parallel, open-label study with IIT (basal-bolus glulisine + glargine administrations) or SC (glargine administration + oral antidiabetic drugs). A SNP of eNOS (rs753482-A>C) and circulating CD34+ and CD34+KDR + progenitor cells were determined. At the end of the study, although HbA1c levels were lower in IIT than in SC (6.9 卤 1.3 % vs. 7.6 卤 1.2 %, p C SNP) and circulating endothelial progenitor cells. 漏 2012 Springer-Verlag