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August 14, 2012Diabetes154 citationsOpen Access

Evidence That Hyperglycemia After Recovery From Hypoglycemia Worsens Endothelial Function and Increases Oxidative Stress and Inflammation in Healthy Control Subjects and Subjects With Type 1 Diabetes

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ACAntonio CerielloANAnna NovialsLSLucia La Sala

Key Result

Hyperglycemia after induced hypoglycemia worsened endothelial dysfunction, oxidative stress, and inflammation compared to normoglycemia, an effect partially counterbalanced by vitamin C infusion.

Structured PICO

Does hyperglycemia during recovery from hypoglycemia worsen endothelial function, oxidative stress, and inflammation in healthy controls and subjects with type 1 diabetes?

P
Population
Normal control individuals and people with type 1 diabetes undergoing induced hypoglycemia and subsequent recovery protocols.
I
Intervention
Recovery from 2-h induced hypoglycemia by reaching hyperglycemia for 2 h (with or without concomitant infusion of vitamin C), followed by 6 h of normal glycemia
C
Comparator
Recovery from 2-h induced hypoglycemia by reaching normoglycemia for 2 h, followed by 6 h of normal glycemia
O
Outcome
Endothelial dysfunction, oxidative stress, and inflammationsurrogate

Hyperglycemia during recovery from hypoglycemia exacerbates endothelial dysfunction, oxidative stress, and inflammation, suggesting an ischemia-reperfusion-like mechanism that may increase cardiovascular risk in type 1 diabetes.

Abstract

Currently there is debate on whether hypoglycemia is an independent risk factor for atherosclerosis, but little attention has been paid to the effects of recovery from hypoglycemia. In normal control individuals and in people with type 1 diabetes, recovery from a 2-h induced hypoglycemia was obtained by reaching normoglycemia or hyperglycemia for another 2 h and then maintaining normal glycemia for the following 6 h. Hyperglycemia after hypoglycemia was also repeated with the concomitant infusion of vitamin C. Recovery with normoglycemia is accompanied by a significant improvement in endothelial dysfunction, oxidative stress, and inflammation, which are affected by hypoglycemia; however, a period of hyperglycemia after hypoglycemia worsens all of these parameters, an effect that persists even after the additional 6 h of normoglycemia. This effect is partially counterbalanced when hyperglycemia after hypoglycemia is accompanied by the simultaneous infusion of vitamin C, suggesting that when hyperglycemia follows hypoglycemia, an ischemia-reperfusion-like effect is produced. This study shows that the way in which recovery from hypoglycemia takes place in people with type 1 diabetes could play an important role in favoring the appearance of endothelial dysfunction, oxidative stress, and inflammation, widely recognized cardiovascular risk factors.

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Cite This Study

Ceriello et al. (2012) studied Type 1 Diabetes and Healthy Controls. Hyperglycemia after hypoglycemia (with or without vitamin C) vs. Normoglycemia after hypoglycemia was evaluated on Endothelial dysfunction, oxidative stress, and inflammation. Hyperglycemia after induced hypoglycemia worsened endothelial dysfunction, oxidative stress, and inflammation compared to normoglycemia, an effect partially counterbalanced by vitamin C infusion.

synapsesocial.com/papers/6aa009263a35f4a2c890ead9https://doi.org/10.2337/db12-0224
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