IN NEWLY DIAGNOSED PATIENTS WITH TYPE 2 DIABETES MELLITUS FLOW-MEDIATED DILATATION IS IMPAIRED AND ASSOCIATED INDEPENDENTLY WITH THE DIAGNOSIS OF DIABETES

Abstract

Objective: Type 2 diabetes mellitus (T2DM) is associated with endothelial dysfunction that mediates long-term complications. However, it is still unclear whether endothelial dysfunction is evident from the early stages of the disease. We aimed to investigate endothelial dysfunction in newly diagnosed and untreated patients with T2DM. Design and method: We enrolled consecutive patients diagnosed with T2DM no longer than 6 months ago, as well as age and gender matched controls. We recorded a detailed medical history, laboratory exams, office and 24-hour blood pressure (BP) levels and ASCVD (Atherosclerotic Cardiovascular Disease) risk. Endothelial dysfunction was estimated with the gold standard non-invasive method, flow mediated dilatation (FMD). Results: We studied 70 individuals aged 56 ± 10 years (29 T2DM and 41 controls). Only 11 T2DM patients were on treatment with metformin and was administered for less than 3 months. T2DM patients had increased office BP (p < 0001) and systolic BP at night (p = 0.037) compared to controls. FMD was also impaired in T2DM (5.3 ± 2.5% versus 7.7 ± 4.5%, p = 0.014). FMD showed a negative association only with T2DM (p = 0.021), day systolic BP (p = 0.031), and positively with HDL (p = 0.038). In the multivariate analysis, T2DM diagnosis was the only independent predictor of FMD. Conclusions: Our results suggest that endothelial dysfunction is evident in newly diagnosed T2DM patients and independently associated with diabetes diagnosis. BP and cholesterol levels were also associated with FMD highlighting the need for early intervention in factors associated with endothelial dysfunction from the early stages of the disease.