Beta-blockers have a beneficial effect upon endothelial function and microalbuminuria in African-American subjects with diabetes and hypertension.

Background: Type 2 diabetes mellitus (T2DM) with microalbuminuria (MA) is associated with increased risk of cardiovascular events (CVE) that may be attenuated by angiotensin-converting enzyme inhibitors (ACEIs), unless microalbuminuria persists (PMA). African-Americans (AA) have a higher prevalence of nephropathy with suboptimal response to ACEIs. We studied the effects of beta-blockers addition and comparative effects of carvedilol with metoprolol on 24-h urinary-albumin excretion (UAE) and endothelial function (EF) in AA with PMA.

Pioglitazone restores endothelial function in patients with type 2 diabetes treated with insulin.

The primary aim of this study was to evaluate the effect of pioglitazone on endothelial function, as assessed by flow-mediated dilatation (FMD) nitroglycerine-induced dilatation (NID) in patients with type 2 diabetes mellitus treated with insulin. A randomized double-blind placebo-controlled trial involved 20 patients with insulin-treated type 2 diabetes. Patients received either pioglitazone 30 mg or placebo for 4 months.

Effect of pharmacological treatments for diabetes on homocysteine.

Hyperhomocysteinemia is a well-established risk factor for cardiovascular disease. The association of hyperhomocysteinemia with diabetes mellitus is complex and may explain some of the risk of CVD in diabetics not explained by traditional risk factors. Both modifiable and non-modifiable factors interact with homocysteine metabolism and determine the plasma homocysteine concentrations.

PPARgamma agonists and vascular risk factors: potential effects on cardiovascular disease.

Peroxisome proliferator-activated receptors (PPARs) are members of the nuclear receptor superfamily comprising four subtypes designated PPARalpha, PPARgamma1, PPARgamma2, and PPARdelta. These are transcription factors that regulate gene expression, thereby controlling energy metabolism. PPARgamma has widespread distribution in the adipose tissue, skeletal muscle, heart, liver, kidney, gut, macrophages, and vascular tissues.

Effects of the thiazolidinediones on cardiovascular risk factors.

Rosiglitazone and pioglitazone are medications from the thiazolidinedione class of compounds currently available for the treatment of type 2 diabetes mellitus. Traditionally used to enhance insulin sensitivity and decrease plasma insulin levels, added applications have emerged beyond those involving glycemic control. Cardiovascular risk factors associated with insulin resistance such as elevated blood pressure, dyslipidemia, abnormal fibrinolysis, and endothelial and vascular dysfunction have been shown to improve after thiazolidinedione treatment.

Is weight loss possible in patients treated with thiazolidinediones? Experience with a low-calorie diet.

Background: Weight gain is a frequent side-effect of thiazolidinediones, possibly related to fluid retention and stimulation of pre-adipocyte differentiation.

Methods: We report our experience with a low-calorie diet (800 cal, sodium content 1500 mmol/day) combined with behavior modification on eight patients treated with thiazolidinediones (six pioglitazone and two rosiglitazone).

Results: All patients had reported previous weight gain following treatment with thiazolidinediones.

Effects of thiazolidinediones on cardiovascular risk factors.

The thiazolidinediones are the insulin sensitizers used in the management of Type 2 diabetes mellitus. These drugs can potentially decrease the risk of cardiovascular disease by correcting the different components of the insulin resistance syndrome.