I3LTE4: Intensive Insulin Therapy and Production of LTE4 in Patients With Diabetes
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About
The primary objective of the study is to assess the effect of a 3-month intensive insulin therapy on urinary leukotriene E4 (LTE4) excretion in patients with diabetes.
Full description
Our group has recently reported the results of a preliminary cross-sectional study, which demonstrated that the urinary LTE4 excretion is increased in patients with type 1 diabetes. With regard to recent human genetic studies showing that polymorphisms in the 5-lipoxygenase (5-LO) promoter and FLAP haplotypes is linked to cardiovascular disease susceptibility our data suggested the potential interest of LTE4 as a non-invasive biomarker of cardiovascular risk. In diabetes mellitus, further studies are required to evaluate the 5-LO pathway after improvement of glucose control and concomitantly with established inflammatory cardiovascular biomarkers.
The secondary objectives are:
Before and after 3-month intensive insulin therapy- Relationship between a marker of platelet activation (urinary 11-dehydro-thromboxan B2 :11-dehydroTXB2) and urinary LTE4- Relationship between inflammatory plasma markers of cardiovascular risk (hs-CRP and fibrinogen) and urinary LTE4- Relationship between a plasma marker of endothelial dysfunction (sICAM-1) and urinary LTE4- Changes in LTE4 according to patient subgroups (patients with type 1 and type 2 diabetes mellitus)
Enrollment
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Inclusion criteria
- diabetes mellitus (type 1 or type 2)
- > 18 year-old
- subject has given free, informed written consent
- subject entitled to health insurance cover
- medical follow-up at the department of Diabetology, Grenoble University Hospital
- inappropriate glucose control (HbA1c > 8.5%) requiring an initiation, or revision, of insulin therapy
Exclusion criteria
- legal incapacity or limited legal competence
- pregnant women
- heart failure
- impaired renal function,defined by a creatinin clearance < 60 ml/mn according to Cockroft formula
- asthma
- respiratory failure
- IV, IM, SC or oral treatment with cortico-steroids for the last 2 months prior to baseline
- current smoking > cigarettes / day
- any infectious disease for the last 2 months prior to baseline
- baseline CRP > 20 mg/l
Trial design
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Interventional model
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