Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 Nov 19;13:140.
doi: 10.1186/s12933-014-0140-9.

The protective effect of the Mediterranean diet on endothelial resistance to GLP-1 in type 2 diabetes: a preliminary report

Antonio Ceriello  1 , Katherine Esposito  2 , Lucia La Sala  3 , Gemma Pujadas  4 , Valeria De Nigris  5 , Roberto Testa  6 , Loredana Bucciarelli  7 , Maurizio Rondinelli  8 , Stefano Genovese  9
Affiliations
Free PMC article
Randomized Controlled Trial

The protective effect of the Mediterranean diet on endothelial resistance to GLP-1 in type 2 diabetes: a preliminary report

Antonio Ceriello et al. Cardiovasc Diabetol. .
Free PMC article
Favorites

Abstract

Background: In type 2 diabetes, acute hyperglycemia worsens endothelial function and inflammation,while resistance to GLP-1 action occurs. All these phenomena seem to be related to the generation of oxidative stress. A Mediterranean diet, supplemented with olive oil, increases plasma antioxidant capacity, suggesting that its implementation can have a favorable effect on the aforementioned phenomena. In the present study, we test the hypothesis that a Mediterranean diet using olive oil can counteract the effects of acute hyperglycemia and can improve the resistance of the endothelium to GLP-1 action.

Methods: Two groups of type 2 diabetic patients, each consisting of twelve subjects, participated in a randomized trial for three months, following a Mediterranean diet using olive oil or a control low-fat diet. Plasma antioxidant capacity, endothelial function, nitrotyrosine, 8-iso-PGF2a, IL-6 and ICAM-1 levels were evaluated at baseline and at the end of the study. The effect of GLP-1 during a hyperglycemic clamp, was also studied at baseline and at the end of the study.

Results: Compared to the control diet, the Mediterranean diet increased plasma antioxidant capacity and improved basal endothelial function, nitrotyrosine, 8-iso-PGF2a, IL-6 and ICAM-1 levels. The Mediterranean diet also reduced the negative effects of acute hyperglycemia, induced by a hyperglycemic clamp, on endothelial function, nitrotyrosine, 8-iso-PGF2a, IL-6 and ICAM-1 levels. Furthermore, the Mediterranean diet improved the protective action of GLP-1 on endothelial function, nitrotyrosine, 8-iso-PGF2a, IL-6 and ICAM-1 levels, also increasing GLP-1-induced insulin secretion.

Conclusions: These data suggest that the Mediterranean diet, using olive oil, prevents the acute hyperglycemia effect on endothelial function, inflammation and oxidative stress, and improves the action of GLP-1, which may have a favorable effect on the management of type 2 diabetes, particularly for the prevention of cardiovascular disease.

Figures

Figure 1
Glycemia, GLP-1, FMD, nitrotyrosine, 8-iso-PGF2a, insulin, IL-6 and ICAM-1 changes during: baseline hyperglycemic clamp (white triangle); Baseline hyperglycemic clamp + GLP-1 (white square); Hyperglycemic clamp after MedDiet intervention (black triangle); Hyperglycemic clamp + GLP-1 after MedDiet intervention (black square). Data are mean ± SE. £ p 
Figure 2
Figure 2
Glycemia, GLP-1, FMD, nitrotyrosine, 8-iso-PGF2a, insulin, IL-6 and ICAM-1 changes during: baseline hyperglycemic clamp (white triangle); Baseline hyperglycemic clamp + GLP-1 (white square); Hyperglycemic clamp after Control diet intervention (black triangle); Hyperglycemic clamp + GLP-1 after Control diet intervention (black square). Data are mean ± SE. £ p 
Figure 3
Δ changes between baseline and after diet intervention. A: Comparison between the Δ of the changes in FMD, nitrotyrosine, 8-iso-PGF2a, insulin, IL-6 and ICAM- during baseline hyperglycemic clamp (grey column) and hyperglycemic clamp after MedDiet intervention (black column). B: Comparison between the Δ of the changes in FMD, nitrotyrosine, 8-iso-PGF2a, insulin, IL-6 and ICAM- during baseline hyperglycemic clamp + GLP-1 (grey column) and hyperglycemic clamp + GLP-1 after MedDiet intervention (black column). *p 
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by 18 articles

See all "Cited by" articles

References

    1. Chaturvedi N. The burden of diabetes and its complications: trends and implications for intervention. Diabetes Res Clin Pract. 2007;76(Suppl 1):S3–S12. doi: 10.1016/j.diabres.2007.01.019. - DOI - PubMed
    1. Ceriello A. Hyperglycaemia and the vessel wall: the pathophysiological aspects on the atherosclerotic burden in patients with diabetes. Eur J Cardiovasc Prev Rehabil. 2010;17(Suppl 1):S15–S19. doi: 10.1097/01.hjr.0000368193.24732.66. - DOI - PubMed
    1. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA. 2007;297:842–857. doi: 10.1001/jama.297.8.842. - DOI - PubMed
    1. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA, PREDIMED Study Investigators Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–1290. doi: 10.1056/NEJMoa1200303. - DOI - PubMed
    1. Zamora-Ros R, Serafini M, Estruch R, Lamuela-Raventós RM, Martínez-González MA, Salas-Salvadó J, Fiol M, Lapetra J, Arós F, Covas MI, Andres-Lacueva C, PREDIMED Study Investigators Mediterranean diet and non enzymatic antioxidant capacity in the PREDIMED study: evidence for a mechanism of antioxidant tuning. Nutr Metab Cardiovasc Dis. 2013;23:1167–1174. doi: 10.1016/j.numecd.2012.12.008. - DOI - PubMed

Publication types