Severe Type 2 Diabetes Induces Reversible Modifications Of Endothelial Progenitor Cells Which Are Ameliorate By Glycemic Control

Background: Circulating endothelial progenitors cells (EPCs) play a critical role in neovascularization and endothelial repair. There is a growing evidence that hyperglycemia related to Diabetes Mellitus (DM) decreases EPC number and function so promoting vascular complications.Aim of the Study: This study investigated whether an intensive glycemic control regimen in Type 2 DM can increase the number of EPCs and restores their function.Methods: Sixty-two patients with Type 2 DM were studied. Patients were tested at baseline and after 3 months of an intensive regimen of glycemic control. The Type 2 DM group was compared to control group of subjects without diabetes. Patients with Type 2 DM (mean age 58.2 +/- 5.4 years, 25.6% women, disease duration of 15.4 +/- 6.3 years) had a baseline HgA1c of 8.7 +/- 0.5% and lower EPC levels (CD34+/KDR+) in comparison to healthy controls (p<0.01).Results: The intensive glycemic control regimen (HgA1c decreased to 6.2 +/- 0.3%) was coupled with a significant increase of EPC levels (mean of 18%, p < 0.04 vs. baseline) and number of EPCs CPUs (p<0.05 vs. baseline).Conclusion: This study confirms that number and bioactivity of EPCs are reduced in patients with Type 2 DM and, most importantly, that the intensive glycemic control in Type 2 DM promotes EPC improvement both in their number and in bioactivity.