Determination of the effect of acute blood sugar regulation with iv insulin infusion on endothelial functions in diabetic hyperglycemic patients

Aim: Determination of the effect of acute blood sugar regulation with iv insulin infusion on endothelial functions in diabetic hyperglycemic patients Method: Forty four hyperglycemic patients who met the inclusion criteria (between the ages of 18 and 75 years, who had been given a decision of iv insulin infusion for end-to-end blood glucose regulation by the endocrinology department) were included in the study after the patients informed and consent forms signed. The study is a single center, prospective and observational drug study. For the evaluation of endothelial functions, brachial artery ultrasonography was performed using Flow Mediated Dilatation (FMD) method. Brachial ultrasonographic evaluation was performed twice in total in patients before the infusion was started and immediately after the infusion was stopped. The distribution of the patients in terms of coronary artery disease, hypertension, hyperlipidemia, atrial fibrillation, chronic renal failure, chronic heart failure, heart valve disorder, thyroid disease, smoking were evaluated and their information was recorded in the case report form. The 12-lead electrocardiography findings (rhythm, heart rate, QRS duration and morphology), systolic blood pressure, diastolic blood pressure, medical treatment, hemogram, urea, creatinine, lipid profile, HbA1c and the blood sugar level before and after insulin infusion was determined and recorded in the case report form. Results: The mean age of the patient group was 54.9 ± 13.6 and 54.5% were female. When the hyperglycemic and normoglycemic periods were compared, the FMD parameter measured in the normoglycemic period was significantly higher (6,13 ± 3,11 versus 10,89 ± 3,65 p <0.001). The FMD value was significantly lower in the DM patient group than in the control group even after treatment (10.89 ± 3.65 vs. 12.84 ± 1.86 p <0.006 for FMD). Conclusion: In patients with type 2 DM, there is a decrease in endothelial function parameters such as FMD during elevated blood glucose levels, which may increase the risk of coronary artery disease and diabetic vascular complications in patients with hyperglycemic DM. In addition, although there is a significant improvement in impaired endothelial functions after glycemic control, FMD values remain low compared to healthy controls. Keywords: Diabetes Mellitus; Hyperglycemia; Endothelial dysfunction; Flow mediated dilatation