The potential of glucose management indicator for the estimation of glucose disposal rate in people with type 1 diabetes.

Background And Aims: Insulin resistance is a growing feature in type 1 diabetes (T1D). It can be quantified by calculating the estimated glucose disposal rate (eGDR) with the Epstein's formula, which includes laboratory-measured glycated hemoglobin (HbA1c). We aimed the current research to assess the agreement between the conventional eGDR formula and an alternative one (eGDR-GMI) incorporating the glucose management indicator (GMI) derived from continuous glucose monitoring (CGM).

Autoimmune thyroiditis and celiac disease do not worsen endothelial function in subjects with type 1 diabetes: an observational study.

Background: Type 1 diabetes (T1D) is frequently associated with autoimmune thyroiditis (AT) and coeliac disease (CD). Whether the coexistence of multiple autoimmune diseases increases cardiovascular risk is uncertain. We evaluated the effects of AT and CD on arterial wall thickening and endothelial function in patients with T1D.

Time in Range Does Not Associate With Carotid Artery Wall Thickness and Endothelial Function in Type 1 Diabetes.

Background: Patients with Type 1 diabetes (T1D) have an increased risk of developing atherosclerosis and complications as myocardial infarction and peripheral artery disease. The thickening of the carotid wall and the brachial artery dysfunction are early and preclinical manifestations of atherosclerosis. The standard marker of care for assessment of glycemic control, glycated hemoglobin, does not associate with early atherosclerosis.

Empagliflozin influences blood viscosity and wall shear stress in subjects with type 2 diabetes mellitus compared with incretin-based therapy.

Background: Cardiovascular protection following empagliflozin therapy is not entirely attributable to the glucose lowering effect. Increased hematocrit might influence the shear stress that is the main force acting on the endothelium, regulating its anti-atherogenic function.

Objective: We designed the study with the aim of investigating the effect of empagliflozin on blood viscosity and shear stress in the carotid arteries.

Diabetes Data Management System to Improve Glycemic Control in People With Type 1 Diabetes: Prospective Cohort Study.

Background: Smartphone and Web technology can improve the health care process, especially in chronic diseases.

Objective: The aim of this study was to investigate whether the use of blood glucose (BG) data management system, which enables connection to smartphones, the Web, the cloud, and downloading, can improve glycemic control in subjects with type 1 diabetes mellitus (T1DM).

Methods: This study was a prospective, single-arm, cohort feasibility study with 6 months of duration.

Body fat and blood rheology: Evaluation of the association between different adiposity indices and blood viscosity.

Background: In recent years, new measures of body adiposity have been introduced: lipid accumulation product (LAP), body adiposity index (BAI) and body shape index (ABSI). These indices have been demonstrated to better associate with cardiovascular disease than other measures of adiposity.

Objectives: The aim of the present study was to evaluate if LAP or BAI better associate with blood viscosity than other measures of adiposity (body mass index, BMI; waist circumference, WC; waist-to-hip ratio, W/HR; waist-to-height ratio, W/HtR).

Hemorheological profiles of subjects with prehypertension.

High blood viscosity is associated with increased peripheral resistance and high blood pressure (BP). Prehypertension refers to a systemic BP of 120-139 mm Hg systolic (SBP) and/or 80-89 mm Hg diastolic (DBP). Subjects with prehypertension have an increased risk of overt hypertension and incident cardiovascular disease compared with subjects who have optimal BP.

Brachial Low-Flow-Mediated Constriction is Associated with Delayed Brachial Flow-Mediated Dilation.

Aim: Flow-mediated vasodilation (FMD) of the brachial artery measures the ability of the artery to dilate after a forearm ischemia lasting for 5 min. During ischemia, and therefore in conditions of low flow, constriction of the brachial artery (L-FMC) has sometimes been reported. The meaning of L-FMC is still unclear.

Red blood cell distribution width predicts two-hours plasma glucose levels during OGTT.

Objective: Red blood cell distribution width (RDW) is a numerical measure, reported as part of a standard complete blood count, usually employed for differential diagnosis of anemic state. Some lines of evidence demonstrate that RDW associates with type 2 diabetes incidence and its complications. To further explore the role of RDW as predictor of abnormal glucose metabolism, we have analyzed the relationship between RDW and 2-hours plasma glucose concentration during an oral glucose tolerance test (OGTT).

Association between blood viscosity and common carotid artery elasticity.

Objective: Elastic properties of the vessel wall are associated with atherosclerosis and major cardiovascular events. Several physiological and pathological conditions can affect arterial elasticity, but few studies have considered the role of hemorheological parameters. The present study aimed to investigate the relationship between hemorheological parameters and vascular stiffness in the carotid artery district.

Clinical Predictors of Progressive Beta-Cell Failure in Type 2 Diabetes.

Objectives: The aim of the study was to identify factors associated with progressive beta-cell failure in a cohort of nonselected subjects with type 2 diabetes.

Methods: Two hundred twenty-four medical records were evaluated. Progressive beta-cell failure was defined as the following: glycated hemoglobin is higher than 7.

Management of Type 2 Diabetes Mellitus through Telemedicine.

Background: Type 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence.

Methods: "Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only.

Blood viscosity but not shear stress associates with delayed flow-mediated dilation.

Purpose: Flow-mediated dilation (FMD) is a complex mechanism involving several mediators, and different hemodynamic forces. Temporally distinct FMD patterns can be elicited by ischemic stimulus. Some subjects dilate early after cuff release, while others dilate later or do not dilate at all.

Decreased platelet aggregation by shear stress-stimulated endothelial cells in vitro: description of a method and first results in diabetes.

The interaction between platelets and endothelium in vivo is a complex phenomenon. Our aim was to develop an in vitro system that mimics the in vivo environment and investigate platelet function in a common pathological condition. Human umbilical vein endothelial cells were used and platelets from 28 type 2 diabetes patients were studied under shear stress conditions.

Delayed vasodilation is associated with cardiovascular risk.

Background: Flow-mediated dilation (FMD) of the brachial artery is widely used to assess cardiovascular risk. In recent years, much attention has been paid to the kinetics of vasodilation in an attempt to better characterize the endothelial function. Here, we investigated whether FMD magnitude and/or latency are most related to individual cardiovascular risk.

Plasma viscosity is increased in subjects with elevated ankle brachial index.

Objective: Peripheral artery occlusive disease (PAOD) is associated with increased cardiovascular risk (CVR). Recently it has been reported that also the increased stiffness of lower limb arteries is associated with increased CVR. In particular, subjects with poorly compressible arteries (PCA) appear to have a CVR even higher than that of subjects with PAOD.

Triglyceride glucose index and common carotid wall shear stress.

Objectives: Alterations in wall shear stress contribute to both clinical and subclinical atherosclerosis. Several conditions such as hypertension, diabetes, and obesity can impair shear stress, but the role of insulin resistance has never been investigated. The present study was designed to investigate whether insulin resistance assessed by TyG Index associates with wall shear stress in the common carotid artery.

Blood viscosity in subjects with normoglycemia and prediabetes.

Objective: Blood viscosity (BV) is higher in diabetic patients and might represent a risk factor for the development of insulin resistance and type 2 diabetes. However, data in subjects with normal glucose or prediabetes are missing. In the current study, we evaluated the relationship between BV and blood glucose in subjects with normal glucose or prediabetes.

Influence of blood lipids on plasma and blood viscosity.

Background And Aim: The relationship between hyperlipidemia and blood and plasma viscosity is not completely clear. While increasing viscosity is often reported with increasing blood lipids, lipid-lowering treatments are often unable to normalize the viscosity values. Aim of this study is to try to clarify the relationship between blood lipids and viscosity.

Delayed flow-mediated vasodilation and carotid atherosclerosis.

Background: In a previous study, we identified temporally distinct postischaemic flow-mediated dilation (FMD) patterns comparing the standard clinical measurement time of 50s postcuff release with measurement at 2 min. The comparison revealed a cohort with the highest FMD at 50s (Early FMD), another cohort with the highest FMD at 2 min (Late FMD) and a third cohort with no FMD (Absent FMD). The aim of this study was to examine whether these temporally distinct FMD patterns associated with different degrees of carotid atherosclerosis.

The effect of HDL cholesterol on blood and plasma viscosity in healthy subjects.

Objective: The influence of lipids on blood and plasma viscosity has not been fully elucidated. In this study we evaluated the contribution of HDL cholesterol to blood and plasma viscosity, in healthy subjects.

Methods: One hundred and forty-four (80 males and 64 females) subjects were enrolled among free-living participants to a cardiovascular disease screening.

Exenatide improves endothelial function assessed by flow mediated dilation technique in subjects with type 2 diabetes: results from an observational research.

The GLP-1 receptor agonist exenatide has been approved for adjunctive treatment of type 2 diabetes. Continuous GLP-1 infusion improves endothelial function in vivo; no evidence about a beneficial effect of exenatide on vascular function has been published. The aim of our observational study was to evaluate whether exenatide would improve brachial artery function evaluated by the flow mediated dilation (FMD) technique, compared with glimepiride, in subjects with type 2 diabetes.

Lack of association between systolic blood pressure and blood viscosity in normotensive healthy subjects.

Objective: A direct relationship between blood pressure and viscosity has frequently been reported, although clear data are not available. To better understand the relationship between these two variables, we evaluated blood viscosity and blood pressure in a group of healthy subjects without cardiovascular risk factors.

Methods: Healthy subjects were selected from participants in a campaign of prevention of cardiovascular disease (n = 103).

Human common carotid wall shear stress as a function of age and gender: a 12-year follow-up study.

Hemodynamic forces play a role in the development of atherosclerosis. Their variations with age have been assessed in cross-sectional, but not longitudinal, studies. The aim of the present study was to investigate in both sexes the age-dependent change in wall shear stress and arterial stiffness in subjects studied twice 12 years apart.

Exenatide improves glycemic variability assessed by continuous glucose monitoring in subjects with type 2 diabetes.

Background: Daily glycemic fluctuation leads to development of long-term complications. The aim of our pilot study was to determine if exenatide reduces glycemic variability, assessed with a continuous glucose monitoring (CGM) system, compared with glimepiride.

Methods: We enrolled six consecutive subjects with type 2 diabetes, for whom exenatide was suggested as second-line treatment, and six control subjects, for whom glimepiride was suggested as second-line treatment.