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Accumulation of lipid in skeletal and cardiac muscle has been associated with insulin resistance and diabetic cardiomyopathy. In skeletal muscle, lipotoxic damage has been suggested to lead to dysfunction of mitochondria. It remains unknown whether lipotoxicity leads to mitochondrial dysfunction in heart as well, and if so, whether this also leads to cardiomyopathy (failure of the heart). Although it has been shown that lipid lowering agents can improve insulin sensitivity, the effect of lowering free fatty acids on cardiac and skeletal muscle mitochondrial function remains unknown. In this study the investigators want to investigate whether lowering cardiac and muscular lipid content will improve mitochondrial and cellular function in type 2 diabetic patients.
To this end, type 2 diabetic patients and body mass index (BMI)-matched controls will be included in a blinded cross-over design, in which subjects will receive a lipid lowering agent (Acipimox) or placebo for 2 weeks in random order. During treatment, diabetes medication will be stopped. Baseline measurements will be performed prior to the study and after each treatment to assess cardiac and muscular lipid accumulation, cardiac function, mitochondrial function and insulin sensitivity.
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Inclusion criteria
Exclusion criteria
Known cardiovascular disease, dyslipidemia, hepatic or renal failure and gastric ulcers.
Insulin dependent Diabetic patients.
Use of lipid lowering agents, except from Statins, as these do not affect triglycerides levels (with exception to Lipitor).
Use of Thiazolidines (glitazone/rosiglitazone/pioglitazone/troglitazone)
Use of anti-coagulants (not thrombocyte-aggregation inhibitors)
Aberrant ECG (with signs of ischemia or cardiac failure or arrythmia's)
Weight gain/loss > 3 kg in the last 6 months.
Hb < 7,3 in women, and < 7,8 in men.
Contraindications for MRI scans:
Subjects, who do not want to be informed about unexpected medical findings, or do not wish that their physician is informed, cannot participate in the study.
Primary purpose
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Interventional model
Masking
31 participants in 2 patient groups, including a placebo group
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Data sourced from clinicaltrials.gov
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