The influence of dietary and other environmental changes on vascular risk markers in type 2 diabetes

Konya, Judit

October 2014

Thesis or dissertation

© 2014 Judit Konya. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance, impaired glycaemia, endothelial, clotting and platelet dysfunction, resulting in increased cardiovascular risk. Cardiovascular parameters are influenced by various environmental and dietary factors.

Two separate studies were undertaken to explore the effect of different soy and/or cocoa dietary interventions on cardiovascular risk makers in type 2 diabetes, and to determine the underlying mechanism. A third study was organized to explore the effect of hypoxia and low humidity on platelet function and clotting indices in addition to microparticle concentration in patients with type 2 diabetes compared to healthy volunteers.

We have shown that the addition of soy with isoflavones improves overall glycaemia, while soy protein alone or either of these two preparations in combination with cocoa are ineffective. The underlying mechanism could be the improvement in postprandial glycaemia as fasting insulin and glucose remained unchanged. Endothelial function did not change as a result of the dietary interventions. We have found that a simulated flight environment increased basal platelet activity in type 2 diabetes patients compared to healthy volunteers, while there was no difference in endothelial function.

These studies showed that dietary soy might modulate glycaemic control through a mechanism, which alters postprandial hyperglycaemia. The effects were dependent on a combination of soy protein with isoflavones as soy protein alone was ineffective. It was shown that mimicking the parameters of a commercial flight affected T2DM with an increase in platelet reactivity that may theoretically increase the risk of a venous thromboembolic episode.

Hull York Medical School, The University of Hull and the University of York
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