title: Rosiglitazone improves endothelial function in patients with type 2 diabetes treated with insulin.
abstract: An increased incidence of myocardial infarction with rosiglitazone in patients with type 2 diabetes mellitus (T2DM) has been reported. This study aimed to assess the effect of rosiglitazone on endothelial function, assessed by flow-mediated dilation (FMD), in 34 patients with advanced T2DM treated with insulin without known cardiovascular disease. Patients were randomised into two groups: no additional treatment was given in 17 patients, while 17 patients were given rosiglitazone for 6 months. Addition of rosiglitazone significantly reduced glycosylated haemoglobin (HbA(1c)) (p < 0.0005) and fasting glucose (p < 0.05) and improved FMD (p < 0.005). No significant changes were observed in the insulin-only group. The single independent predictor of FMD improvement was rosiglitazone treatment (p = 0.048). These results show that, in patients with advanced T2DM treated with insulin, addition of rosiglitazone may have a beneficial effect on endothelial function. Further research is needed to investigate why this beneficial effect does not translate into improved cardiovascular prognosis in these patients.
authors.affiliation: Michaelidion Cardiac Centre, University of Ioannina, Greece.
authors.forename: Katerina K
authors.initials: KK
authors.lastname: Naka
authors.forename: Katerina
authors.initials: K
authors.lastname: Papathanassiou
authors.forename: Aris
authors.initials: A
authors.lastname: Bechlioulis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Pappas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kazakos
authors.forename: Chryssanthi
authors.initials: C
authors.lastname: Kanioglou
authors.forename: Michail I
authors.initials: MI
authors.lastname: Papafaklis
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Kostoula
authors.forename: Patra
authors.initials: P
authors.lastname: Vezyraki
authors.forename: Demetrios
authors.initials: D
authors.lastname: Makriyiannis
authors.forename: Agathocles
authors.initials: A
authors.lastname: Tsatsoulis
authors.forename: Lampros K
authors.initials: LK
authors.lastname: Michalis
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006115:Greece; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000077154:Rosiglitazone; D045162:Thiazolidinediones; C517652:hemoglobin A1c protein, human