title: Cerebral hemodynamics and systemic endothelial function are already impaired in well-controlled type 2 diabetic patients, with short-term disease.
abstract: OBJECTIVE
  Impaired cerebral vasomotor reactivity (VMR) and flow-mediated dilation (FMD) were found in selected subgroups of type 2 diabetes mellitus (T2DM) patients with long-term disease. Our study aimed to evaluate cerebral hemodynamics, systemic endothelial function and sympatho-vagal balance in a selected population of well-controlled T2DM patients with short-term disease and without cardiac autonomic neuropathy (CAN).
  
  
  METHODS
  Twenty-six T2DM patients with short-term (4.40±4.80 years) and well-controlled (HbA1C = 6.71±1.29%) disease, without any complications, treated with diet and/or metformin, were consecutively recruited. Eighteen controls, comparable by sex and age, were enrolled also.
  
  
  RESULTS
  FMD and shear rate FMD were found to be reduced in T2DM subjects with short-term disease (8.5% SD 3.5 and 2.5 SD 1.3, respectively) compared to controls (15.4% SD 4.1 and 3.5 SD 1.4; p<.001 and p<.05). T2DM patients also displayed reduced VMR values than controls (39.4% SD 12.4 vs 51.7%, SD 15.5; p<.05). Sympatho-vagal balance was not different in T2DM patients compared to healthy subjects. FMD and shear rate FMD did not correlate with VMR in T2DM patients or in controls (p>.05).
  
  
  CONCLUSIONS
  In well-controlled T2DM patients with short-term disease cerebral hemodynamics and systemic endothelial function are altered while autonomic balance appeared to be preserved.
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Rome, Italy ; Department of Neurology, S. Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Palazzo
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Maggio
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Altavilla
authors.affiliation: Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Di Flaviani
authors.affiliation: Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Giordani
authors.affiliation: Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Malandrucco
authors.affiliation: Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Picconi
authors.affiliation: Department of Neurology, S. Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Passarelli
authors.affiliation: SeSMIT, Service for Medical Statistics & IT, Fatebenefratelli Association for Research, Isola Tiberina, Rome, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Pasqualetti
authors.affiliation: Department of Neurology, S. Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Ercolani
authors.affiliation: Department of Neurology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Vernieri
authors.affiliation: Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Frontoni
mesh_terms: D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology*; D003927:Diet, Diabetic; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006439:Hemodynamics; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D013997:Time Factors; D014664:Vasodilation / Q000502:physiology; D014666:Vasomotor System / Q000503:physiopathology
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; C517652:hemoglobin A1c protein, human