Chugh S N, Dabla Surekha, Jain Vinish, Chugh Kiran, Sen Jyotsna
Department of Medicine, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak & Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India.
J Assoc Physicians India. 2010 Aug;58:478-80.
To evaluate the endothelial functions before and after glycemic control in type II diabetes mellitus.
It was an open, randomized and comparative study on 30 patients of type 2 diabetes mellitus. The study was of 12 weeks spread over 5 visits. The initial visit (visit 1) is for screening of patients. Other visits (visits 2 to 5) constituted the follow up of patients. The primary efficacy parameters included blood sugar (fasting and postprandial) done on each visit and glycosylated hemoglobin (HbA1c) done at visits 1 and 5. Based on glycosylated hemoglobin (HbA1c) only poorly controlled and fairly controlled patients were included in the study. Brachial artery flow mediated vasodilatation (FMD) was studied in all these patient at visits 1 and 5 to see the effect of glycemic control on endothelial functions. Results obtained were statistically analyzed with appropriate method.
There was a significant improvement in endothelial functions in patients with fair, good and excellent control of diabetes. During uncontrolled state (HbA1c 10.08 +/- 0.48%) FMD was lowest, i.e., 2.88 +/- 0.53 at 1st week which improved to 11.94 +/- 3.33 at 12th week with control of diabetes (HbA1c 6.74 +/- 0.16%). The FMD in patients who had fair control (HbAlc 8.45 +/- 0.30%) in the beginning was 6.74 +/- 2.43% and after excellent control in these patients FMD rises to 12.81 +/- 3.16%.
Our data showed that the endothelial functions improved sequentially with control of diabetes from fair to good to excellent glycemic control.
评估2型糖尿病患者血糖控制前后的内皮功能。
这是一项针对30例2型糖尿病患者的开放性、随机对照研究。研究为期12周，分5次就诊。首次就诊（第1次就诊）用于患者筛查。其他就诊（第2至5次就诊）为患者随访。主要疗效参数包括每次就诊时测定的血糖（空腹和餐后）以及第1次和第5次就诊时测定的糖化血红蛋白（HbA1c）。仅根据糖化血红蛋白（HbA1c）将控制不佳和控制尚可的患者纳入研究。在第1次和第5次就诊时对所有这些患者进行肱动脉血流介导的血管舒张（FMD）研究，以观察血糖控制对内皮功能的影响。所得结果采用适当方法进行统计学分析。
糖尿病控制良好、较好和优秀的患者内皮功能有显著改善。在未控制状态（HbA1c 10.08±0.48%）下，第1周时FMD最低，即2.88±0.53，随着糖尿病得到控制（HbA1c 6.74±0.16%），第12周时升至11.94±3.33。开始时控制尚可（HbAlc 8.45±0.30%）的患者FMD为6.74±2.43%，在这些患者实现优秀控制后，FMD升至12.81±3.16%。
我们的数据表明，随着糖尿病从尚可控制到良好控制再到优秀控制，内皮功能依次得到改善。
