Charlottesville, Virginia 22906

  • Hyperglycemia, Postprandial


To the investigator's knowledge, there are no data available in the current literature regarding the acute effects of postprandial hyperglycemia and insulin timing on myocardial perfusion in DM1. Observational studies using CEU in DM2 subjects demonstrate that postprandial hyperglycemia determines myocardial perfusion defects. The investigator hypothesizes that the combination of postprandial hyperglycemia and insulin increases pulse wave velocity (i.e., aortic stiffness) and myocardial vasoconstriction, thereby reducing myocardial perfusion in DM1 when compared to healthy controls. Furthermore, the investigator hypothesizes in DM1, that dosing insulin before meal intake will ameliorate these cardiovascular defects.

Study summary:

The investigator will compare 16 DM1 and 16 Healthy control subjects( 18-35 yrs) measuring pulse wave velocity ( PWV), augmentation index ( AI), flow-mediated dilation ( FMD) and myocardial perfusion ( contrast enhanced ultrasound CEU) before and 2 hours after ingesting a mixed meal (40% of each subject's daily estimated caloric need, with 50%, 30%, 20% from carbohydrates, fat and protein, respectively). DM1 subjects will have 2 study admissions: A) DM1 subjects will have an injection of insulin 15 minutes before ingesting a mixed meal. B) DM1 subjects will have an injection of insulin 15 min after ingesting a meal .


Inclusion Criteria: - Healthy with no chronic illness - Age 18-35 years - BMI ≤ 30 (wt kg/ht m2) - Normal screening labs or no clinically significant values - DM1 subjects have DM1 based on WHO diagnostic criteria for > 1 year - A fasting plasma glucose level >126 mg/dl (7.0 mmol/l) - A casual plasma glucose >200 mg/dl (11.1 mmol/l) - In the absence of unequivocal hyperglycemia, the diagnosis must be confirmed on a subsequent day. - Subjects using sensor-augmented insulin pump therapy and/or artificial pancreas (closed loop system) will be included Exclusion Criteria: - • Smoking presently or have quit < 2 years. - BP >140/90 mmHg - BMI >30 (wt kg/ht m2) - Pulse oximetry <90% - Elevated LDL cholesterol > 160 mg/dl - HbA1c ≥ 9 % - Use of statins, calcium channel blocker, ACE, ARB, nitrates, alpha-beta blockers or diuretics - History of cardiac, cerebrovascular, gastrointestinal, liver, renal decease or cancer - Presence of an intracardiac or intrapulmonary shunt (we will screen for this by auscultation during the physical exam by PI). - Retinopathy (beyond mild non proliferative retinopathy) - Urine albumin/creatinine ratio > 300 mg per g - Pregnant or breastfeeding. - Known hypersensitivity to perflutren (contained in Definity

Study is Available At:

Original ID:




Secondary ID:


Study Acronym:


Brief Title:

Effect of Postprandial Hyperglycemia on Vasculature in DM1 and Healthy Adults

Official Title:

Effect of Postprandial Hyperglycemia on Vasculature in DM1 and Healthy Adults

Overall Status:


Study Phase:




Minimum Age:

18 Years

Maximum Age:

35 Years

Quick Facts

Healthy Volunteers
Oversight Has DMC
Study Is FDA Regulated
Study Is Section 801
Has Expanded Access

Study Source:

University of Virginia

Oversight Authority:

There was an error processing this request

Reasons Why Stopped:

Study Type:


Study Design:

Number of Arms:


Number of Groups:


Total Enrollment:


Enrollment Type:


Overall Contact Information

Official Name:William Horton, MD
Principal Investigator
University of Virginia, Department of Endocrinology
Primary Contact:William B Horton, MD
Backup Contact:Lee Hartline, MEd

Study Dates

Start Date:April 6, 2021
Completion Date:January 2025
Completion Type:Anticipated
Primary Completion Date:January 2025
Primary Completion Type:Anticipated
Verification Date:April 2021
Last Changed Date:April 27, 2021
First Received Date:January 25, 2021

Study Outcomes

Outcome Type:Primary Outcome
Measure:Cardiac contrast enhanced ultrasound ( CEU)
Time Frame:baseline and 2 hours after a meal
Safety Issues:False
Description:Measurement of change in myocardial perfusion
Outcome Type:Secondary Outcome
Measure:Pulse Wave Velocity ( PWV)
Time Frame:baseline and 2 hours after a meal
Safety Issues:False
Description:Measurement of change in central artery stiffness
Outcome Type:Secondary Outcome
Measure:Augmentation Index ( AI)
Time Frame:baseline and 2 hours after a meal
Safety Issues:False
Description:Measurement of change in central artery stiffness
Outcome Type:Secondary Outcome
Measure:Flow Mediated Dilation
Time Frame:baseline and 2 hours after a meal
Safety Issues:False
Description:Vascular measure of change in conduit artery stiffness

Study Interventions

Intervention Type:Dietary Supplement
Name:Mixed Meal
Description:the meal will be 40% of each subject's daily estimated caloric need, with 50%, 30%, 20% from carbohydrates, fat and protein, respectively
Arm Name:DM1

Study Arms

Study Arm Type:Other
Arm Name:Healthy Control
Description:Healthy subjects 18-35 years of age
Study Arm Type:Other
Arm Name:DM1
Description:DM1 subjects (18-35 yrs) have DM1 based on WHO diagnostic criteria for > 1 year

Study Agencies

Agency Class:Other
Agency Type:Lead Sponsor
Agency Name:University of Virginia

Samples and Retentions

Study Population: 16 Healthy controls and 16 DM1
Sample Method:Probability Sample

Study References

Reference Type:Reference
Citation:Lind M, Svensson AM, Kosiborod M, Gudbjörnsdottir S, Pivodic A, Wedel H, Dahlqvist S, Clements M, Rosengren A. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014 Nov 20;371(21):1972-82. doi: 10.1056/NEJMoa1408214.
Reference Type:Reference
Citation:Lee AK, Warren B, Lee CJ, McEvoy JW, Matsushita K, Huang ES, Sharrett AR, Coresh J, Selvin E. The Association of Severe Hypoglycemia With Incident Cardiovascular Events and Mortality in Adults With Type 2 Diabetes. Diabetes Care. 2018 Jan;41(1):104-111. doi: 10.2337/dc17-1669. Epub 2017 Nov 10.
Reference Type:Reference
Citation:Goto A, Goto M, Terauchi Y, Yamaguchi N, Noda M. Association Between Severe Hypoglycemia and Cardiovascular Disease Risk in Japanese Patients With Type 2 Diabetes. J Am Heart Assoc. 2016 Mar 9;5(3):e002875. doi: 10.1161/JAHA.115.002875. Review. Erratum in: J Am Heart Assoc. 2016 Jun;5(6). pii: e002075. doi: 10.1161/JAHA.116.002075.
Reference Type:Reference
Citation:Aryangat AV, Gerich JE. Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk. Vasc Health Risk Manag. 2010 Mar 24;6:145-55. Review.
Reference Type:Reference
Citation:Ceriello A, Hanefeld M, Leiter L, Monnier L, Moses A, Owens D, Tajima N, Tuomilehto J. Postprandial glucose regulation and diabetic complications. Arch Intern Med. 2004 Oct 25;164(19):2090-5. Review.
Reference Type:Reference
Citation:Cavalot F, Petrelli A, Traversa M, Bonomo K, Fiora E, Conti M, Anfossi G, Costa G, Trovati M. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab. 2006 Mar;91(3):813-9. Epub 2005 Dec 13.
Reference Type:Reference
Citation:Livingstone SJ, Looker HC, Hothersall EJ, Wild SH, Lindsay RS, Chalmers J, Cleland S, Leese GP, McKnight J, Morris AD, Pearson DW, Peden NR, Petrie JR, Philip S, Sattar N, Sullivan F, Colhoun HM. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study. PLoS Med. 2012;9(10):e1001321. doi: 10.1371/journal.pmed.1001321. Epub 2012 Oct 2.
Reference Type:Reference
Citation:Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, Goff DC Jr, Bigger JT, Buse JB, Cushman WC, Genuth S, Ismail-Beigi F, Grimm RH Jr, Probstfield JL, Simons-Morton DG, Friedewald WT. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2545-59. doi: 10.1056/NEJMoa0802743. Epub 2008 Jun 6.
Reference Type:Reference
Citation:Currie CJ, Peters JR, Tynan A, Evans M, Heine RJ, Bracco OL, Zagar T, Poole CD. Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study. Lancet. 2010 Feb 6;375(9713):481-9. doi: 10.1016/S0140-6736(09)61969-3. Epub 2010 Jan 26.
Reference Type:Reference
Citation:Saisho Y. Glycemic variability and oxidative stress: a link between diabetes and cardiovascular disease? Int J Mol Sci. 2014 Oct 13;15(10):18381-406. doi: 10.3390/ijms151018381. Review.
Reference Type:Reference
Citation:Risso A, Mercuri F, Quagliaro L, Damante G, Ceriello A. Intermittent high glucose enhances apoptosis in human umbilical vein endothelial cells in culture. Am J Physiol Endocrinol Metab. 2001 Nov;281(5):E924-30.
Reference Type:Reference
Citation:Quagliaro L, Piconi L, Assaloni R, Martinelli L, Motz E, Ceriello A. Intermittent high glucose enhances apoptosis related to oxidative stress in human umbilical vein endothelial cells: the role of protein kinase C and NAD(P)H-oxidase activation. Diabetes. 2003 Nov;52(11):2795-804.
Reference Type:Reference
Citation:Piconi L, Quagliaro L, Assaloni R, Da Ros R, Maier A, Zuodar G, Ceriello A. Constant and intermittent high glucose enhances endothelial cell apoptosis through mitochondrial superoxide overproduction. Diabetes Metab Res Rev. 2006 May-Jun;22(3):198-203.
Reference Type:Reference
Citation:Horváth EM, Benko R, Kiss L, Murányi M, Pék T, Fekete K, Bárány T, Somlai A, Csordás A, Szabo C. Rapid 'glycaemic swings' induce nitrosative stress, activate poly(ADP-ribose) polymerase and impair endothelial function in a rat model of diabetes mellitus. Diabetologia. 2009 May;52(5):952-61. doi: 10.1007/s00125-009-1304-0. Epub 2009 Mar 5.
Reference Type:Reference
Citation:Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, Boemi M, Giugliano D. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008 May;57(5):1349-54. doi: 10.2337/db08-0063. Epub 2008 Feb 25.
Reference Type:Reference
Citation:Monnier L, Mas E, Ginet C, Michel F, Villon L, Cristol JP, Colette C. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA. 2006 Apr 12;295(14):1681-7.
Reference Type:Reference
Citation:Tang X, Li S, Wang Y, Wang M, Yin Q, Mu P, Lin S, Qian X, Ye X, Chen Y. Glycemic variability evaluated by continuous glucose monitoring system is associated with the 10-y cardiovascular risk of diabetic patients with well-controlled HbA1c. Clin Chim Acta. 2016 Oct 1;461:146-50. doi: 10.1016/j.cca.2016.08.004. Epub 2016 Aug 5.
Reference Type:Reference
Citation:Ghouse J, Skov MW, Kanters JK, Lind B, Isaksen JL, Blanche P, Haunsø S, Køber L, Svendsen JH, Olesen MS, Holst AG, Gerds TA, Nielsen JB. Visit-to-Visit Variability of Hemoglobin A(1c) in People Without Diabetes and Risk of Major Adverse Cardiovascular Events and All-Cause Mortality. Diabetes Care. 2019 Jan;42(1):134-141. doi: 10.2337/dc18-1396. Epub 2018 Oct 23.
Reference Type:Reference
Citation:Su G, Mi SH, Tao H, Li Z, Yang HX, Zheng H, Zhou Y, Tian L. Impact of admission glycemic variability, glucose, and glycosylated hemoglobin on major adverse cardiac events after acute myocardial infarction. Diabetes Care. 2013 Apr;36(4):1026-32. doi: 10.2337/dc12-0925. Epub 2013 Jan 24.
Reference Type:Reference
Citation:Wadén J, Forsblom C, Thorn LM, Gordin D, Saraheimo M, Groop PH; Finnish Diabetic Nephropathy Study Group. A1C variability predicts incident cardiovascular events, microalbuminuria, and overt diabetic nephropathy in patients with type 1 diabetes. Diabetes. 2009 Nov;58(11):2649-55. doi: 10.2337/db09-0693. Epub 2009 Aug 3.
Reference Type:Reference
Citation:Snell-Bergeon JK, Roman R, Rodbard D, Garg S, Maahs DM, Schauer IE, Bergman BC, Kinney GL, Rewers M. Glycaemic variability is associated with coronary artery calcium in men with Type 1 diabetes: the Coronary Artery Calcification in Type 1 Diabetes study. Diabet Med. 2010 Dec;27(12):1436-42. doi: 10.1111/j.1464-5491.2010.03127.x.
Reference Type:Reference
Citation:Sundell J, Knuuti J. Insulin and myocardial blood flow. Cardiovasc Res. 2003 Feb;57(2):312-9. Review.
Reference Type:Reference
Citation:Coggins M, Lindner J, Rattigan S, Jahn L, Fasy E, Kaul S, Barrett E. Physiologic hyperinsulinemia enhances human skeletal muscle perfusion by capillary recruitment. Diabetes. 2001 Dec;50(12):2682-90.
Reference Type:Reference
Citation:Vincent MA, Dawson D, Clark AD, Lindner JR, Rattigan S, Clark MG, Barrett EJ. Skeletal muscle microvascular recruitment by physiological hyperinsulinemia precedes increases in total blood flow. Diabetes. 2002 Jan;51(1):42-8.
Reference Type:Reference
Citation:de Ferranti SD, de Boer IH, Fonseca V, Fox CS, Golden SH, Lavie CJ, Magge SN, Marx N, McGuire DK, Orchard TJ, Zinman B, Eckel RH. Type 1 diabetes mellitus and cardiovascular disease: a scientific statement from the American Heart Association and American Diabetes Association. Diabetes Care. 2014 Oct;37(10):2843-63. doi: 10.2337/dc14-1720. Epub 2014 Aug 11. Review.
Reference Type:Reference
Citation:Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes. 2014 Aug 15;5(4):444-70. doi: 10.4239/wjd.v5.i4.444. Review.
Reference Type:Reference
Citation:Priya G, Kalra S. A Review of Insulin Resistance in Type 1 Diabetes: Is There a Place for Adjunctive Metformin? Diabetes Ther. 2018 Feb;9(1):349-361. doi: 10.1007/s13300-017-0333-9. Epub 2017 Nov 14. Review.
Reference Type:Reference
Citation:Alessa T, Szeto A, Chacra W, Mendez A, Goldberg RB. High HDL-C prevalence is common in type 1 diabetes and increases with age but is lower in Hispanic individuals. J Diabetes Complications. 2015 Jan-Feb;29(1):105-7. doi: 10.1016/j.jdiacomp.2014.08.011. Epub 2014 Sep 6.
Reference Type:Reference
Citation:Nørgaard K, Feldt-Rasmussen B, Borch-Johnsen K, Saelan H, Deckert T. Prevalence of hypertension in type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1990 Jul;33(7):407-10.
Reference Type:Reference
Citation:Corbin KD, Driscoll KA, Pratley RE, Smith SR, Maahs DM, Mayer-Davis EJ; Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON). Obesity in Type 1 Diabetes: Pathophysiology, Clinical Impact, and Mechanisms. Endocr Rev. 2018 Oct 1;39(5):629-663. doi: 10.1210/er.2017-00191. Review.
Reference Type:Reference
Citation:Gorst C, Kwok CS, Aslam S, Buchan I, Kontopantelis E, Myint PK, Heatlie G, Loke Y, Rutter MK, Mamas MA. Long-term Glycemic Variability and Risk of Adverse Outcomes: A Systematic Review and Meta-analysis. Diabetes Care. 2015 Dec;38(12):2354-69. doi: 10.2337/dc15-1188. Review.
Reference Type:Reference
Citation:Bonke FC, Donnachie E, Schneider A, Mehring M. Association of the average rate of change in HbA1c with severe adverse events: a longitudinal evaluation of audit data from the Bavarian Disease Management Program for patients with type 2 diabetes mellitus. Diabetologia. 2016 Feb;59(2):286-93. doi: 10.1007/s00125-015-3797-z. Epub 2015 Oct 30.
Reference Type:Reference
Citation:Wan EY, Fung CS, Fong DY, Lam CL. Association of variability in hemoglobin A1c with cardiovascular diseases and mortality in Chinese patients with type 2 diabetes mellitus - A retrospective population-based cohort study. J Diabetes Complications. 2016 Sep-Oct;30(7):1240-7. doi: 10.1016/j.jdiacomp.2016.05.024. Epub 2016 May 31.
Reference Type:Reference
Citation:Lee CL, Sheu WH, Lee IT, Lin SY, Liang WM, Wang JS, Li YF. Trajectories of fasting plasma glucose variability and mortality in type 2 diabetes. Diabetes Metab. 2018 Mar;44(2):121-128. doi: 10.1016/j.diabet.2017.09.001. Epub 2017 Oct 9.
Reference Type:Reference
Citation:Wightman SS, Sainsbury CAR, Jones GC. Visit-to-visit HbA1c variability and systolic blood pressure (SBP) variability are significantly and additively associated with mortality in individuals with type 1 diabetes: An observational study. Diabetes Obes Metab. 2018 Apr;20(4):1014-1017. doi: 10.1111/dom.13193. Epub 2018 Jan 18.
Reference Type:Reference
Citation:Gerbaud E, Darier R, Montaudon M, Beauvieux MC, Coffin-Boutreux C, Coste P, Douard H, Ouattara A, Catargi B. Glycemic Variability Is a Powerful Independent Predictive Factor of Midterm Major Adverse Cardiac Events in Patients With Diabetes With Acute Coronary Syndrome. Diabetes Care. 2019 Apr;42(4):674-681. doi: 10.2337/dc18-2047. Epub 2019 Feb 6.
Reference Type:Reference
Citation:Vincent MA, Clerk LH, Lindner JR, Price WJ, Jahn LA, Leong-Poi H, Barrett EJ. Mixed meal and light exercise each recruit muscle capillaries in healthy humans. Am J Physiol Endocrinol Metab. 2006 Jun;290(6):E1191-7.
Reference Type:Reference
Citation:Chai W, Liu J, Jahn LA, Fowler DE, Barrett EJ, Liu Z. Salsalate attenuates free fatty acid-induced microvascular and metabolic insulin resistance in humans. Diabetes Care. 2011 Jul;34(7):1634-8. doi: 10.2337/dc10-2345. Epub 2011 May 26.
Reference Type:Reference
Citation:Subaran SC, Sauder MA, Chai W, Jahn LA, Fowler DE, Aylor KW, Basu A, Liu Z. GLP-1 at physiological concentrations recruits skeletal and cardiac muscle microvasculature in healthy humans. Clin Sci (Lond). 2014 Aug;127(3):163-70. doi: 10.1042/CS20130708.
Reference Type:Reference
Citation:Jahn LA, Hartline L, Rao N, Logan B, Kim JJ, Aylor K, Gan LM, Westergren HU, Barrett EJ. Insulin Enhances Endothelial Function Throughout the Arterial Tree in Healthy But Not Metabolic Syndrome Subjects. J Clin Endocrinol Metab. 2016 Mar;101(3):1198-206. doi: 10.1210/jc.2015-3293. Epub 2016 Jan 12.
Reference Type:Reference
Citation:Liu J, Jahn LA, Fowler DE, Barrett EJ, Cao W, Liu Z. Free fatty acids induce insulin resistance in both cardiac and skeletal muscle microvasculature in humans. J Clin Endocrinol Metab. 2011 Feb;96(2):438-46. doi: 10.1210/jc.2010-1174. Epub 2010 Nov 3.
Reference Type:Reference
Citation:Zorach B, Shaw PW, Bourque J, Kuruvilla S, Balfour PC Jr, Yang Y, Mathew R, Pan J, Gonzalez JA, Taylor AM, Meyer CH, Epstein FH, Kramer CM, Salerno M. Quantitative cardiovascular magnetic resonance perfusion imaging identifies reduced flow reserve in microvascular coronary artery disease. J Cardiovasc Magn Reson. 2018 Feb 22;20(1):14. doi: 10.1186/s12968-018-0435-1.
Reference Type:Reference
Citation:Jamiołkowska M, Jamiołkowska I, Łuczyński W, Tołwińska J, Bossowski A, Głowińska Olszewska B. Impact of Real-Time Continuous Glucose Monitoring Use on Glucose Variability and Endothelial Function in Adolescents with Type 1 Diabetes: New Technology--New Possibility to Decrease Cardiovascular Risk? J Diabetes Res. 2016;2016:4385312. doi: 10.1155/2016/4385312. Epub 2015 Nov 16.
Reference Type:Reference
Citation:Rana O, Byrne CD, Kerr D, Coppini DV, Zouwail S, Senior R, Begley J, Walker JJ, Greaves K. Acute hypoglycemia decreases myocardial blood flow reserve in patients with type 1 diabetes mellitus and in healthy humans. Circulation. 2011 Oct 4;124(14):1548-56. doi: 10.1161/CIRCULATIONAHA.110.992297. Epub 2011 Sep 12.
Reference Type:Reference
Citation:Abdelmoneim SS, Hagen ME, Mendrick E, Pattan V, Wong B, Norby B, Roberson T, Szydel T, Basu R, Basu A, Mulvagh SL. Acute hyperglycemia reduces myocardial blood flow reserve and the magnitude of reduction is associated with insulin resistance: a study in nondiabetic humans using contrast echocardiography. Heart Vessels. 2013 Nov;28(6):757-68. doi: 10.1007/s00380-012-0305-y. Epub 2012 Nov 23.
Reference Type:Reference
Citation:Davis SN, Duckworth W, Emanuele N, Hayward RA, Wiitala WL, Thottapurathu L, Reda DJ, Reaven PD; Investigators of the Veterans Affairs Diabetes Trial. Effects of Severe Hypoglycemia on Cardiovascular Outcomes and Death in the Veterans Affairs Diabetes Trial. Diabetes Care. 2019 Jan;42(1):157-163. doi: 10.2337/dc18-1144. Epub 2018 Nov 19.
Reference Type:Reference
Citation:Zinman B, Marso SP, Christiansen E, Calanna S, Rasmussen S, Buse JB; LEADER Publication Committee on behalf of the LEADER Trial Investigators. Hypoglycemia, Cardiovascular Outcomes, and Death: The LEADER Experience. Diabetes Care. 2018 Aug;41(8):1783-1791. doi: 10.2337/dc17-2677. Epub 2018 Jun 14.
Reference Type:Reference
Citation:Ceriello A. The emerging role of post-prandial hyperglycaemic spikes in the pathogenesis of diabetic complications. Diabet Med. 1998 Mar;15(3):188-93. Review.
Reference Type:Reference
Citation:Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe. Lancet. 1999 Aug 21;354(9179):617-21.
Reference Type:Reference
Citation:Strojek K, Raz I, Jermendy G, Gitt AK, Liu R, Zhang Q, Jacober SJ, Milicevic Z. Factors Associated With Cardiovascular Events in Patients With Type 2 Diabetes and Acute Myocardial Infarction. J Clin Endocrinol Metab. 2016 Jan;101(1):243-53. doi: 10.1210/jc.2015-1962. Epub 2015 Nov 23.
Reference Type:Reference
Citation:Scognamiglio R, Negut C, De Kreutzenberg SV, Tiengo A, Avogaro A. Postprandial myocardial perfusion in healthy subjects and in type 2 diabetic patients. Circulation. 2005 Jul 12;112(2):179-84. Epub 2005 Jul 5.
Reference Type:Reference
Citation:Scognamiglio R, Negut C, de Kreutzenberg SV, Tiengo A, Avogaro A. Effects of different insulin regimes on postprandial myocardial perfusion defects in type 2 diabetic patients. Diabetes Care. 2006 Jan;29(1):95-100.
Reference Type:Reference
Citation:Haas AV, Rosner BA, Kwong RY, Rao AD, Garg R, Di Carli MF, Adler GK. Sex Differences in Coronary Microvascular Function in Individuals With Type 2 Diabetes. Diabetes. 2019 Mar;68(3):631-636. doi: 10.2337/db18-0650. Epub 2018 Nov 8.
Reference Type:Reference
Citation:Bagi Z, Broskova Z, Feher A. Obesity and coronary microvascular disease - implications for adipose tissue-mediated remote inflammatory response. Curr Vasc Pharmacol. 2014 May;12(3):453-61. Review.
Reference Type:Reference
Citation:Larghat AM, Swoboda PP, Biglands JD, Kearney MT, Greenwood JP, Plein S. The microvascular effects of insulin resistance and diabetes on cardiac structure, function, and perfusion: a cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging. 2014 Dec;15(12):1368-76. doi: 10.1093/ehjci/jeu142. Epub 2014 Aug 12.
Reference Type:Reference
Citation:Barletta G, Del Bene MR. Myocardial perfusion echocardiography and coronary microvascular dysfunction. World J Cardiol. 2015 Dec 26;7(12):861-74. doi: 10.4330/wjc.v7.i12.861. Review.
Reference Type:Reference
Citation:Kuruvilla S, Janardhanan R, Antkowiak P, Keeley EC, Adenaw N, Brooks J, Epstein FH, Kramer CM, Salerno M. Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone. JACC Cardiovasc Imaging. 2015 Feb;8(2):172-80. doi: 10.1016/j.jcmg.2014.09.020. Epub 2015 Jan 7.
Reference Type:Reference
Citation:Monnier L, Colette C, Owens DR. Glycemic variability: the third component of the dysglycemia in diabetes. Is it important? How to measure it? J Diabetes Sci Technol. 2008 Nov;2(6):1094-100.
Reference Type:Reference
Citation:Miller RG, Costacou T, Orchard TJ. Risk Factor Modeling for Cardiovascular Disease in Type 1 Diabetes in the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study: A Comparison With the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC). Diabetes. 2019 Feb;68(2):409-419. doi: 10.2337/db18-0515. Epub 2018 Nov 8.
Reference Type:Reference
Citation:Tam CS, Xie W, Johnson WD, Cefalu WT, Redman LM, Ravussin E. Defining insulin resistance from hyperinsulinemic-euglycemic clamps. Diabetes Care. 2012 Jul;35(7):1605-10. doi: 10.2337/dc11-2339. Epub 2012 Apr 17.
Reference Type:Reference
Citation:Chan A, Barrett EJ, Anderson SM, Kovatchev BP, Breton MD. Muscle microvascular recruitment predicts insulin sensitivity in middle-aged patients with type 1 diabetes mellitus. Diabetologia. 2012 Mar;55(3):729-36. doi: 10.1007/s00125-011-2402-3. Epub 2011 Dec 14.
Reference Type:Reference
Citation:Breton MD, Patek SD, Lv D, Schertz E, Robic J, Pinnata J, Kollar L, Barnett C, Wakeman C, Oliveri M, Fabris C, Chernavvsky D, Kovatchev BP, Anderson SM. Continuous Glucose Monitoring and Insulin Informed Advisory System with Automated Titration and Dosing of Insulin Reduces Glucose Variability in Type 1 Diabetes Mellitus. Diabetes Technol Ther. 2018 Aug;20(8):531-540. doi: 10.1089/dia.2018.0079. Epub 2018 Jul 6.
Reference Type:Reference
Citation:Monnier L, Colette C, Wojtusciszyn A, Dejager S, Renard E, Molinari N, Owens DR. Toward Defining the Threshold Between Low and High Glucose Variability in Diabetes. Diabetes Care. 2017 Jul;40(7):832-838. doi: 10.2337/dc16-1769. Epub 2016 Dec 30.
Reference Type:Reference
Citation:Kovatchev B, Cobelli C. Glucose Variability: Timing, Risk Analysis, and Relationship to Hypoglycemia in Diabetes. Diabetes Care. 2016 Apr;39(4):502-10. doi: 10.2337/dc15-2035.
Reference Type:Reference
Citation:Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, Garg S, Heinemann L, Hirsch I, Amiel SA, Beck R, Bosi E, Buckingham B, Cobelli C, Dassau E, Doyle FJ 3rd, Heller S, Hovorka R, Jia W, Jones T, Kordonouri O, Kovatchev B, Kowalski A, Laffel L, Maahs D, Murphy HR, Nørgaard K, Parkin CG, Renard E, Saboo B, Scharf M, Tamborlane WV, Weinzimer SA, Phillip M. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care. 2017 Dec;40(12):1631-1640. doi: 10.2337/dc17-1600. Review.
Reference Type:Reference
Citation:Ohkuma T, Komorita Y, Peters SAE, Woodward M. Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals. Diabetologia. 2019 Sep;62(9):1550-1560. doi: 10.1007/s00125-019-4926-x. Epub 2019 Jul 18. Review.
Reference Type:Reference
Citation:Lind M, Bounias I, Olsson M, Gudbjörnsdottir S, Svensson AM, Rosengren A. Glycaemic control and incidence of heart failure in 20,985 patients with type 1 diabetes: an observational study. Lancet. 2011 Jul 9;378(9786):140-6. doi: 10.1016/S0140-6736(11)60471-6. Epub 2011 Jun 24.
Reference Type:Reference
Citation:Tromp J, Lim SL, Tay WT, Teng TK, Chandramouli C, Ouwerkerk W, Wander GS, Sawhney JPS, Yap J, MacDonald MR, Ling LH, Sattar N, McMurray JJV, Richards AM, Anand I, Lam CSP; ASIAN-HF Investigators. Microvascular Disease in Patients With Diabetes With Heart Failure and Reduced Ejection Versus Preserved Ejection Fraction. Diabetes Care. 2019 Sep;42(9):1792-1799. doi: 10.2337/dc18-2515. Epub 2019 Jul 10.
Reference Type:Reference
Citation:Su MY, Lin LY, Tseng YH, Chang CC, Wu CK, Lin JL, Tseng WY. CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF. JACC Cardiovasc Imaging. 2014 Oct;7(10):991-7. doi: 10.1016/j.jcmg.2014.04.022. Epub 2014 Sep 17.
Reference Type:Reference
Citation:Ng AC, Auger D, Delgado V, van Elderen SG, Bertini M, Siebelink HM, van der Geest RJ, Bonetti C, van der Velde ET, de Roos A, Smit JW, Leung DY, Bax JJ, Lamb HJ. Association between diffuse myocardial fibrosis by cardiac magnetic resonance contrast-enhanced T₁ mapping and subclinical myocardial dysfunction in diabetic patients: a pilot study. Circ Cardiovasc Imaging. 2012 Jan;5(1):51-9. doi: 10.1161/CIRCIMAGING.111.965608. Epub 2011 Dec 1. Erratum in: Circ Cardiovasc Imaging. 2012 Mar;5(2):e25.
Reference Type:Reference
Citation:Mavrogeni S, Bratis K, Gavra P, Fousteris E, Markussis V, Kolovou G, van Wijk K, Hautemann D, Reiber JH, Melidonis A. Stress cardiac magnetic resonance reveals myocardial perfusion impairment in asymptomatic diabetes mellitus type I, missed by the routine non-invasive evaluation. Int J Cardiol. 2013 Sep 10;167(6):e167-9. doi: 10.1016/j.ijcard.2013.04.170. Epub 2013 May 9.
Reference Type:Reference
Citation:Turkbey EB, Backlund JY, Genuth S, Jain A, Miao C, Cleary PA, Lachin JM, Nathan DM, van der Geest RJ, Soliman EZ, Liu CY, Lima JA, Bluemke DA; DCCT/EDIC Research Group. Myocardial structure, function, and scar in patients with type 1 diabetes mellitus. Circulation. 2011 Oct 18;124(16):1737-46. doi: 10.1161/CIRCULATIONAHA.111.022327. Epub 2011 Sep 26.

Data Source:

Date Processed: July 28, 2021

Modifications to this listing: Only selected fields are shown, please use the link below to view all information about this clinical trial.

If you would like to be contacted by the clinical trial representative please fill out the form below.