Influence of glucose control, lipoproteins, and haemostasis function on brachial endothelial reactivity and carotid intima-media area, stiffness and diameter in Type 1 diabetes mellitus patients.
BACKGROUND
The objectives of this study were to determine the influence of glucose control on lipoprotein and haemostasis variables in Type 1 diabetes mellitus patients and to evaluate the global impact of these metabolic risk factors on brachial artery reactivity and carotid artery atherosclerosis, stiffness and diameter.


METHODS
Follow up of Type 1 diabetes patients randomized to insulin-intensive conventional treatment (ICT, n = 29) or insulin-standard treatment (ST, n = 25) in the Stockholm Diabetes Intervention Study (SDIS) more than 14 years ago.


RESULTS
The intensive conventional treatment patients had lower glycosylated haemoglobin (HbA1c) compared with the ST patients, i.e. 7.01 (SD 0.51) vs. 8.31 (0.97), while concentrations of the lipoprotein and haemostasis variables analyzed were virtually similar. The carotid artery intima-media area was associated with high HbA1c, high serum (S)-cholesterol levels, and low high-density lipoprotein (HDL)-cholesterol levels. Carotid artery stiffness was associated with high systolic blood pressure, high HbA1c, high fibrinogen, and high HDL-cholesterol. Brachial artery endothelial reactivity was higher for women and those with low S-cholesterol.


CONCLUSIONS
In patients with Type 1 diabetes, glucose control appeared to have no effect on either lipoproteins or haemostasis variable concentrations. Poor glucose control, and high levels of S-cholesterol, systolic blood pressure and plasma fibrinogen were associated with development of atherosclerosis, thus emphasising the importance of global risk factor control in patients with Type 1 diabetes mellitus.
Johansson
J
J
Karolinska Institute, Stockholm, Sweden. janovej@hotmail.com
Reichard
P
P
Jensen-Urstad
K
K
Rosfors
Stefan
S
Jensen-Urstad
M
M
D000328:Adult; D001161:Arteriosclerosis / Q000097:blood / Q000209:etiology*; D001786:Blood Glucose / Q000378:metabolism*; D002340:Carotid Artery Diseases / Q000097:blood / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000473:pathology / Q000517:prevention & control; D005260:Female; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D012307:Risk Factors; D017539:Tunica Intima / Q000503:physiopathology; D017540:Tunica Media / Q000503:physiopathology
D001786:Blood Glucose; D008074:Lipoproteins