Type 2 Diabetes Mellitus Clinical Trial
Official title:
The Impact of Free Fatty Acid Reduction on Vascular Function and Skeletal Muscle Glucose Utilization in Type 2 Diabetes Mellitus
This study will test the hypothesis that reduction in release of free fatty acids from adipocytes will restore insulin-mediated endothelium-dependent vasodilation and skeletal muscle glucose metabolism in subject with type 2 diabetes.
During the past two decades, there has been a steady increase in the incidence of diabetes
mellitus, such that nearly 17 million people are now afflicted. The vast majority of these
have type 2 diabetes. Over the next 40 years, the type 2 diabetic population in the United
States is expected to increase to nearly 30 million.
Diabetes substantially increases the risk of atherosclerosis, and thereby, cardiovascular
morbidity and mortality. Indeed, cardiovascular disease causes more than 50% of the mortality
in patients with diabetes. People with type 2 diabetes manifest two cardinal signs of
dysmetabolism: hyperglycemia and insulin resistance. Insulin resistance is a progressive
phenomenon that occurs well before the onset of frank diabetes, and results in alterations in
insulin signaling. Experimental studies suggest that insulin signaling is required for
vascular homeostasis, and its impairment is associated with endothelial dysfunction. In the
clinical setting, insulin resistance is associated with atherosclerosis and predicts
cardiovascular events independent of hyperglycemia. Therefore, we will study the importance
of insulin signaling in endothelial biology in humans and the effects of free fatty acids on
endothelial function in people with type 2 diabetes.
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