Metabolic Causes of Thrombosis in Type 2 Diabetes - Question 1
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The purpose of this study is to learn more about why patients with diabetes have increased heart attacks, strokes and other illnesses due to blood clots causing blockage of a blood vessel. The proposed protocol will study the separate and combined effects of hyperglycemia and hyperinsulinemia on endothelial function and fibrinolytic balance in Type 2 DM. Our hypothesis is that hyperglycemia, rather than hyperinsulinemia, is responsible for the dysregulation of fibrinolytic balance in diabetics.
Condition or disease
Type 2 Diabetes
Other: Hyperinsulinemic Hyperglycemic Clamp
This study will test the hypothesis that hyperglycemia will impair, while hyperinsulinemia will improve endothelial function and vascular fibrinolytic balance in type 2 DM. As discussed above, their roles in the increased prevalence of thrombotic events occurring in diabetics have not been defined. More recent data supports insulin as profibrinolytic and hyperglycemia to cause endothelial dysfunction. Conclusive studies are lacking in diabetic subjects. Furthermore, preliminary data from this lab indicates that in non-diabetic controls, hyperglycemia results in a prothrombotic state by increasing plasma PAI-1 and reducing tPA levels. The proposed protocol will study the separate and combined effects of hyperglycemia and hyperinsulinemia on endothelial function and fibrinolytic balance in Type 2 DM.
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Ages Eligible for Study:
18 Years to 60 Years (Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
16 ( 8 female/ 8 male) Type 2 diabetic patients age 18-60 yrs
16 ( 8 female/ 8 male) Non-diabetic controls age and weight matched
Body mass index 25-52 kgm2
Female volunteers of childbearing potential: negative HCG pregnancy test
Volunteers over 40 years old: normal baseline ECG
For those with type 2 diabetes: HBA1C 6.5-10%
Prior history of poor health: any current or prior disease condition that alters carbohydrate metabolism and prior cardiac events and/or evidence for cardiac disease
History of cerebrovascular incidents
Subjects unable to give voluntary informed consent
Subjects with a recent medical illness
Subjects with known liver or kidney disease
Subjects on anticoagulant drugs, anemic, or with known bleeding diseases