Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients

Antonio Ceriello, Katherine Esposito, Ludovica Piconi, Michael A. Ihnat, Jessica E. Thorpe, Roberto Testa, Massimo Boemi, Dario Giugliano

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE-To explore the possibility that oscillating glucose may outweigh A1C levels in determining the risk for cardiovascular diabetes complications. RESEARCH DESIGN AND METHODS-A euinsulinemic hyperglycemic clamp at 5, 10, and 15 mmol/l glucose was given in increasing steps as a single "spike" or oscillating between basal and high levels over 24 h in normal subjects and type 2 diabetic patients. Flow-mediated dilatation, a marker of endothelial function, and plasma 3-nitrotyrosine and 24-h urinary excretion rates of free 8-iso PGF2α, two markers of oxidative stress, were measured over 48 h postclamp. RESULTS-Glucose at two different levels (10 and 15 mmol/l) resulted in a concentration-dependent fasting blood glucose-independent induction of both endothelial dysfunction and oxi-dative stress in both normal and type 2 diabetic patients. Oscillating glucose between 5 and 15 mmol/l every 6 h for 24 h resulted in further significant increases in endothelial dysffunc-tion and oxidative stress compared with either continuous 10 or 15 mmol/l glucose. CONCLUSIONS-These data suggest that oscillating glucose can have more deleterious effects than constant high glucose on endothelial function and oxidative stress, two key players in favoring cardiovascular complications in diabetes. Concomitant vitamin C infusion can reverse this impairment.

Original languageEnglish
Pages (from-to)1349-1354
Number of pages6
JournalDiabetes
Volume57
Issue number5
DOIs
Publication statusPublished - May 2008

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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