부산대학교 도서관

In this study we determine the effects of reducing blood glucose on mean arterial blood pressure (MAP) and hematocrit (Hct) in patients with type 2 diabetes who are not responding to conventional treatment in an intensive treatment program 1 year after initiation of treatment. Data on MAP, glucose and Hct was obtained from 21 diabetic type 2 individuals subjected to personalized treatment and compared (paired statistics) to pretreatment conditions. Exclusion criteria were severe retinopathy, diabetic nephropathy, amputation of diabetic foot and increased glucose>50 mg/dl. Treatment was the combined administration of glibenclamide and metformin dosed to obtain a reduction of glucose levels. Exercise and strict adherence to a prescribed diet were prescribed in all cases. One year after initiation of therapy, glucose decreased from 219 ± 87 to 158±51 mg/dl (p<0.002), Hct increased from 41.6 ± 3.2 to 44.7±2.9% (p<0.001) and MAP decreased from 100.6 ± 11.0 to 94.3±7.2 mmHg (p<0.001). There were no statically significant changes in cholesterol and triglyceride concentrations. The patients lost weight (72.5±12.6 to 70.3±13.0 kg, p<0.001) and lowered blood creatinine concentration from 1.04±0.24 to 0.95±0.25 mg/dl, p<0.05. The increase in Hct should correspond to an increase in blood viscosity of about 12%, however blood pressure, and presumably vascular resistance, decreased by 6%. It is proposed that these effects are in part related to improved kidney function resulting in increased Hct and blood viscosity which increases vascular wall shear stress and NO bioavailability leading to a vasodilator effect. [ABSTRACT FROM AUTHOR]