Search for a Link Between the Different Variables for Glycaemia and Oxidative Stress or Impaired HDL Function

Influence of Glycaemic Variability on Oxidative Stress and High-density Lipoprotein (HDL) Function in Type-1 Diabetes

As glycaemic variability on the one hand and hypoglycaemia on the other are associated with oxidative stress and inflammation, they are likely, in type-1 diabetic patients, to affect the oxidation of lipoproteins and HDL function, by altering their anti-atherogenic properties.

The aim of this study is thus to determine, in patients with Type 1 Diabetic (T1D) who will wear a glycaemic Holter for 1 week, the glycaemia parameters (mean glycaemia, duration of hypoglycaemia, duration of hyperglycaemia, mean amplitude of glycaemic excursions) associated with proatherogenic alterations in lipoproteins, in particular:

• LDL oxidation
• HDL oxidation and alterations of HDL function (anti-inflammatory capacity, antioxidant capacity)

Inclusion Criteria:

• Patients who have provided written consent
• Patients with national health insurance cover

Patients with T1D

• T1D Patients treated with insulin via a pump or multiple injections
• HbA1c < 9.5 %

Control patients

• Normal fasting glycaemia (< 6.1 mmol/L)
• Age > 18 years, matched for sex and age with T1D patients

All patients

• Normal serum HDL cholesterol (> 1.04 mmol/L in men, > 1.30 mmol:L in women)
• Serum LDL cholesterol < 5 mmol/L
• triglyceridemia < 1.7 mmol/L
• Waist circumference < 102 cm in men, < 88 cm in women

Exclusion Criteria:

• Smoking
• Kidney failure (Creatinine clearance< 60 ml/min/1.73 m2)
• Liver failure
• Dysthyroidism
• Medication that interferes with lipoprotein metabolism (lipid-lowering agents, oestroprogestative, anti-HIV, corticoids, retinoic acid), unless stopped for at least one 1 month
• Antioxidant (vitamin E, dietary supplements, DHA)
• Pregnancy of more than 15d