title: Influence of Postprandial Hyperglycemic Conditions on Arterial Stiffness in Patients With Type 2 Diabetes.
abstract: BACKGROUND
  Patients with type 2 diabetes (T2D) are at an increased risk of cardiovascular disease.
  
  
  OBJECTIVE
  The objective of the study was to determine whether postprandial hyperglycemia affects arterial function in T2D.
  
  
  METHODS
  A single-center, open-label study of three groups of men were studied: 1) T2D patients with albuminuria (n = 22), 2) T2D patients without albuminuria (n = 24), and 3) nondiabetic controls (n = 25). Patients were randomized to a two-period crossover study schedule, ingesting breakfast, with or without insulin lispro (to induce low or high postprandial glycemia).
  
  
  METHODS
  Arterial stiffness was assessed by calculating pulse wave velocity (PWV) and augmentation index using applanation tonometry, and endothelial dysfunction was assessed using peripheral arterial tonometry, 30 minutes before breakfast and up to 240 minutes after breakfast.
  
  
  RESULTS
  At baseline, arterial stiffness was increased in patients. When adjusted for age and body mass index, in a combined group of patients with and without albuminuria, brachial PWV was higher during low (P = .032) and high (P = .038) postprandial glycemia vs controls. These differences were driven by the albuminuria group vs controls during low (P = .014) and high (P = .018) postprandial glycemia. No differences were observed in aortic PWV, augmentation index, or peripheral arterial tonometry ratio between patients and controls. Endothelin-1 and IL-6 were higher, and superoxide dismutase was lower, during postprandial hyperglycemia in T2D patients vs controls.
  
  
  CONCLUSIONS
  In patients with T2D and albuminuria, brachial PWV was higher under postprandial hyperglycemic conditions, relative to controls. These data suggest that hyperglycemia induces an increase in stiffness of intermediate-sized arteries. We found no changes in other parts of the arterial bed.
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gordin
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Markku
authors.initials: M
authors.lastname: Saraheimo
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Jaana
authors.initials: J
authors.lastname: Tuomikangas
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Aino
authors.initials: A
authors.lastname: Soro-Paavonen
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Karri
authors.initials: K
authors.lastname: Paavonen
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Birgit
authors.initials: B
authors.lastname: Steckel-Hamann
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Francois
authors.initials: F
authors.lastname: Vandenhende
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Loizos
authors.initials: L
authors.lastname: Nicolaou
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Imre
authors.initials: I
authors.lastname: Pavo
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Veikko
authors.initials: V
authors.lastname: Koivisto
authors.affiliation: Folkhälsan Institute of Genetics (D.G., M.S., J.T., A.S.-P., C.F., K.P., P.-H.G.), Folkhälsan Research Center, Biomedicum Helsinki, FI-00014 Helsinki, Finland; Abdominal Center Nephrology FI-00290 (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), University of Helsinki and Helsinki University Hospital, and Research Program Unit (D.G., M.S., J.T., A.S.-P., C.F., P.-H.G.), Department of Diabetes and Obesity, University of Helsinki FI-00014, and Division of Cardiology (K.P.), Department of Medicine, Helsinki University Central Hospital, FI-00290 Helsinki, Finland; Eli Lilly Export SA (B.S.-H.), Vernier, 1214 Geneva, Switzerland; ClinBAY (F.V., L.N.), 1470 Genappe, Belgium; Eli Lilly (I.P.), A-1030 Vienna, Austria; Eli Lilly (V.K.), 00330 Helsinki, Finland; and Baker IDI and Diabetes Institute (P.-H.G.), Melbourne, 3004 Victoria, Australia.
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D063177:Pulse Wave Analysis; D017534:Radial Artery / Q000503:physiopathology; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D007328:Insulin