RESUMEN
BACKGROUND: An increased thickness of the carotid artery wall is thought to be a sign of early atherosclerosis. We have investigated the effects of gemfibrozil in asymptomatic diabetic hyperlipidaemic subjects on the 12-month progression of arterial wall thickness. METHODS: Forty non-insulin-dependent diabetics with hyperlipidaemia and without hypertension were studied. After a 4-week run-in-diet phase, oral gemfibrozil was administered (900 mg once daily) in 20 patients randomly selected, while 20 subjects were treated only with diet. The two groups were matched for age, sex, body mass index (BMI), duration of diabetes and glycaemic control. Arterial wall thickness was measured as the mean of the maximum intima of media thickness (IMT) in 16 carotid segments by B-mode ultrasound. RESULTS: Baseline size of IMT and lipid values were similar in both groups. The IMT increase over 12 months was 5% in the gemfibrozil group vs 15.2% in subjects treated by diet alone. CONCLUSIONS: We conclude that gemfibrozil treatment may be useful in decreasing the progression rate of arterial wall thickness.
Asunto(s)
Arteriosclerosis/tratamiento farmacológico , Enfermedades de las Arterias Carótidas/tratamiento farmacológico , Diabetes Mellitus Tipo 2/complicaciones , Gemfibrozilo/uso terapéutico , Hiperlipidemias/complicaciones , Hipolipemiantes/uso terapéutico , Administración Oral , Arteriosclerosis/complicaciones , Arteriosclerosis/diagnóstico , Glucemia/metabolismo , Enfermedades de las Arterias Carótidas/complicaciones , Enfermedades de las Arterias Carótidas/diagnóstico , Arteria Carótida Común/diagnóstico por imagen , Colesterol/sangre , Diabetes Mellitus Tipo 2/sangre , Femenino , Estudios de Seguimiento , Gemfibrozilo/administración & dosificación , Hemoglobina Glucada/metabolismo , Humanos , Hiperlipidemias/sangre , Hiperlipidemias/tratamiento farmacológico , Hipolipemiantes/administración & dosificación , Masculino , Persona de Mediana Edad , Radiografía , Resultado del Tratamiento , Triglicéridos/sangre , UltrasonografíaRESUMEN
The aim of this study was to assess the prevalence of peripheral vascular disease (PVD) in newly diagnosed diabetic patients and the possible relationship to various risk factors. One hundred and twenty non-insulin-dependent diabetics (NIDDs) aged 50-70 years and 93 non-diabetic subjects, matched for age and sex, were studied using Doppler ultrasound. None had a history of alcoholic abuse, while 12 diabetic and 8 non-diabetic subjects were smokers. There were 6 male subjects with PVD (5 NIDDs, 1 control subject) and 2 female diabetic subjects with PVD (p: No SD). In group of male diabetics with PVD, HDL-C levels were found to be lower and triglyceride levels higher, than in those without diabetes, but the difference was not significant. Hypertension, body mass index and smoking were not associated with the presence of PVD in either female or male diabetic subjects. It is concluded that, although PVD tended to be more common in men with newly diagnosed diabetes, the overall findings support the view that macrovascular disease is related to duration of diabetes.
Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Angiopatías Diabéticas/epidemiología , Enfermedades Vasculares Periféricas/epidemiología , Factores de Edad , Angiopatías Diabéticas/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Vasculares Periféricas/diagnóstico por imagen , Prevalencia , Factores de Riesgo , Factores Sexuales , UltrasonografíaRESUMEN
We investigated the relationship between the size of the pancreas in non-insulin-dependent diabetic patients (NIDDs) and normal subjects, and also the possible correlation between pancreatic size in diabetics and basal C-peptide concentrations. Eighty-four non-insulin-dependent diabetics and eighty control subjects matched for age, sex and body mass index (BMI) were studied, using a realtime sector system, with which we measured the head and body of the pancreas in cm2. Scans were performed twice in 50 subjects with no significant difference. Both the head and the body of the pancreas were significantly smaller in diabetics (4.60 +/- 1.10 cm2, 5.92 +/- 1.53 cm2, respectively) than in normal subjects (6.09 +/- 1.62 cm2, 7.43 +/- 2.14 cm2) (p less than 0.001). The mean total area of the pancreas for the diabetics was 10.53 +/- 2.45 cm2, and for the controls 13.53 +/- 3.60 cm2 (p less than 0.001). No correlation was found between the total area of the pancreas and the BMI in the two groups. In the diabetic group, there was a positive correlation between C-peptide and the total area of the pancreas (r = 0.30, p less than 0.01). We concluded that the size of the pancreas is smaller in NIDDs than in healthy controls, and there is a positive correlation with the basal C-peptide concentration.
Asunto(s)
Diabetes Mellitus Tipo 2/patología , Páncreas/patología , Péptido C/análisis , Femenino , Hemoglobina Glucada/análisis , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The aim of this study was to assess the prevalence and the possible risk-factors for the development of peripheral vascular disease (PVD) in sulfonylurea-treated diabetic patients with proteinuria. Fifty non-insulin-dependent diabetics (NIDDs) with proteinuria (greater than 500 mg/24 h), with age less than or equal to 75 years and duration of diabetes greater than or equal to 5 years, and forty-eight NIDDs without proteinuria, matched for age, sex, body mass index (BMI), duration of diabetes and glycaemic control, were studied using Doppler ultrasound. Risk factors analysed included smoking, hypertension and metabolic indices (cholesterol, HDL-C, triglycerides). The prevalence of PVD was 44% in the proteinuric disease group compared to 14.6% in those without proteinuria (p less than 0.01). Among the risk factors analysed, hypertension and triglyceride concentration were significantly higher in the proteinuric diabetics (p less than 0.01), while HDL-C levels were found to be significantly lower in this group (p less than 0.05). We conclude that the prevalence of PVD was significantly higher in NIDDs with proteinuria. Furthermore, proteinuric patients had higher blood pressure and low HDL-C.