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Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1812
Federico P. 1, Acerra G. 1, Salomone P. 1, Mattera E. 2, Madrid E. 1, Marino R. 1, Silvestroni A. 2, Fasano C. 2, Ingenito A. 1, Panico A. 1, Ragozzino G. 1, Del Guercio R. 2
1 Unità di Semeiotica e Metodologia Medica, Dipartimento di Internistica Clinica e Sperimentale, Seconda Università di Napoli, Napoli;
2 Unità e Servizio Speciale di Angiologia Medica, Dipartimento di Internistica Clinica e Sperimentale, Seconda Università di Napoli, Napoli
Aim. To assess the efficacy of Iloprost, a synthetic prostacyclin analog, on the glycemic control in type 2 diabetic patients with peripheral artery disease (PVD).
Methods. Forty patients (M/F 24/16; age 66±7 y; BMI 25.43±4.21 kg/m2) with PVD, type 2 diabetes (group A, 20 patients: 10 hypoglycemics e 10 insulin) and non diabetic (group B, 20 patients) were recruited. At entry, metabolic study [(oral glucose tolerance test - OGTT, 100 g os) group A; (24-h glycemic profile) group B; insulinemia and C-peptide (during OGTT or profile), HbA1c, insulin-resistance by HOMA test]. Moreover, PT, PTT, INR, fibrinogen, protein C, protein S, platelet, in vivo coagulation time and coagulation factor (V, VII, VIII, X, XII) were assayed and body composition (BIA Akern 101/S) performed. Then, Iloprost 0.050 mg e.v. in saline 250 cc (20 ml/h in 12-14 h/die/10 d). Student’s t-test was calculated and statistical significance was inferred at P<0.05.
Results. Patients showed significant fasting and poststimuli blood glucose and insulinemia and HbA1c improvements such as dose reduction for hypoglycemics or insulin. Initial claudication distance raised from 100±11 m to 200±25 m.
Conclusion. Iloprost was effective and well tolerated in improving insulin-resistance in type 2 diabetic patients with PVD acting on endothelial dysfunction by reduction in vascular tone.