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Randomized Controlled Trial
, 12, 97

Vitamin C Further Improves the Protective Effect of GLP-1 on the Ischemia-Reperfusion-Like Effect Induced by Hyperglycemia Post-Hypoglycemia in Type 1 Diabetes

Randomized Controlled Trial

Vitamin C Further Improves the Protective Effect of GLP-1 on the Ischemia-Reperfusion-Like Effect Induced by Hyperglycemia Post-Hypoglycemia in Type 1 Diabetes

Antonio Ceriello et al. Cardiovasc Diabetol.


Background: It has been reported that hyperglycemia following hypoglycemia produces an ischemia-reperfusion-like effect in type 1 diabetes. In this study the possibility that GLP-1 has a protective effect on this phenomenon has been tested.

Methods: 15 type 1 diabetic patients underwent to five experiments: a period of two hours of hypoglycemia followed by two hours of normo-glycemia or hyperglycemia with the concomitant infusion of GLP-1 or vitamin C or both. At baseline, after 2 and 4 hours, glycemia, plasma nitrotyrosine, plasma 8-iso prostaglandin F2alpha, sCAM-1a, IL-6 and flow mediated vasodilation were measured.

Results: After 2 h of hypoglycemia, flow mediated vasodilation significantly decreased, while sICAM-1, 8-iso-PGF2a, nitrotyrosine and IL-6 significantly increased. While recovering with normoglycemia was accompanied by a significant improvement of endothelial dysfunction, oxidative stress and inflammation, a period of hyperglycemia after hypoglycemia worsens all these parameters. These effects were counterbalanced by GLP-1 and better by vitamin C, while the simultaneous infusion of both almost completely abolished the effect of hyperglycemia post hypoglycemia.

Conclusions: This study shows that GLP-1 infusion, during induced hyperglycemia post hypoglycemia, reduces the generation of oxidative stress and inflammation, improving the endothelial dysfunction, in type 1 diabetes. Furthermore, the data support that vitamin C and GLP-1 may have an additive protective effect in such condition.


Figure 1
Figure 1
Glycemia, sICAM-1, flow-mediated dilation (FMD), nitrotyrosine, IL-6 and 8-iso-PGF2a in type 1 diabetes during the experiments.

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