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Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
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Central hemodynamic modifications in diabetes mellitus.

Davide Agnoletti1, Ari Lieber, Yi Zhang

  • 1Paris Descartes University, AP-HP, Diagnosis and Therapeutic Center, Hôtel-Dieu, 1 place du Parvis Notre Dame, 75004 Paris, France; Department of Internal Medicine, University of Bologna, Via Albertoni 15, 40138 Bologna, Italy.

Atherosclerosis
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Summary

Hypertensive diabetics exhibit greater arterial stiffness than non-diabetics, with insulin therapy potentially worsening this condition independently of blood pressure control.

Keywords:
Arterial stiffnessCentral hemodynamicsDiabetes mellitusInsulin therapyPulse pressure amplificationPulse wave velocity

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Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Hypertension Research

Background:

  • Arterial stiffness is influenced by age, MAP, and HR in hypertension.
  • Factors affecting arterial stiffness in diabetes mellitus are not fully understood.

Purpose of the Study:

  • To compare central hemodynamics in diabetics versus non-diabetic controls with similar MAP.
  • To investigate factors influencing arterial stiffness in diabetic patients.

Main Methods:

  • Compared central hemodynamics (central blood pressure, PWV, AIx, PPA) in 126 diabetics and 203 controls using applanation tonometry.
  • Collected anthropometric, laboratory, and clinical data.
  • Adjusted for age, gender, MAP, heart rate, and metabolic syndrome.

Main Results:

  • Diabetics showed significantly higher PWV and AIx after adjusting for age, gender, MAP, and HR.
  • PWV remained significantly higher in diabetics after further adjustment for metabolic syndrome.
  • PWV in diabetics did not correlate with MAP, suggesting non-hemodynamic factors contribute to arterial stiffening.
  • Insulin therapy was associated with increased PWV, independent of other variables.

Conclusions:

  • Hypertensive diabetics have greater arterial stiffness than hypertensive controls.
  • Arterial stiffening in diabetes is influenced by multiple factors beyond hemodynamics.
  • Insulin therapy is linked to increased arterial stiffness, warranting further investigation into its direct or indirect effects.