title: High-polyphenol chocolate reduces endothelial dysfunction and oxidative stress during acute transient hyperglycaemia in Type 2 diabetes: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To investigate the effects of high-polyphenol chocolate upon endothelial function and oxidative stress in Type 2 diabetes mellitus during acute transient hyperglycaemia induced following a 75-g oral glucose challenge.
  
  
  METHODS
  Ten subjects with Type 2 diabetes underwent a double-blinded randomized controlled crossover study. A 75-g oral glucose load was used to induce hyperglycaemia, which was administered to participants 60 min after they had ingested either low (control) or high-polyphenol chocolate. Participants undertook testing at weekly intervals, following an initial cocoa-free period. Endothelial function was assessed by both functional [reactive hyperaemia peripheral artery tonometry (EndoPAT-2000) and serum markers (including intercellular adhesion molecule 1, P-selectin and P-selectin glycoprotein ligand 1]. Urinary 15-F2t-isoprostane adjusted for creatinine was used as an oxidative stress marker. Measurements were made at baseline and 2 h post-ingestion of the glucose load.
  
  
  RESULTS
  Prior consumption of high-polyphenol chocolate before a glucose load improved endothelial function (1.7 ± 0.1 vs. 2.3 ± 0.1%, P = 0.01), whereas prior consumption of control chocolate resulted in a significant increase in intercellular adhesion molecule 1 (321.1 ± 7.6 vs. 373.6 ± 10.5 ng/ml, P = 0.04) and 15-F2t-isoprostane (116.8 ± 5.7 vs. 207.1 ± 5.7 mg/mol, P = 0.02). Analysis of percentage changes from baseline comparing control and high-polyphenol chocolate showed a significant improvement for high-polyphenol chocolate in both measures of endothelial function (P < 0.05) and for urinary 15-F2t-isoprostane (P = 0.04).
  
  
  CONCLUSIONS
  High-polyphenol chocolate protected against acute hyperglycaemia-induced endothelial dysfunction and oxidative stress in individuals with Type 2 diabetes mellitus.
authors.affiliation: Department of Clinical Science, University of Chester, Chester, UK. d.mellor@chester.ac.uk
authors.forename: D D
authors.initials: DD
authors.lastname: Mellor
authors.forename: L A
authors.initials: LA
authors.lastname: Madden
authors.forename: K A
authors.initials: KA
authors.lastname: Smith
authors.forename: E S
authors.initials: ES
authors.lastname: Kilpatrick
authors.forename: S L
authors.initials: SL
authors.lastname: Atkin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002099:Cacao; D002182:Candy; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy*; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000178:diet therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D010865:Pilot Projects; D059808:Polyphenols / Q000008:administration & dosage*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D059808:Polyphenols