Saturday, February 4, 2023

Bromocriptine in Type 1 Diabetes – Interactive Doctor

Adolescents with type 1 diabetes (T1D) who took bromocriptine, a drug used to treat Parkinson’s disease and type 2 diabetes, had lower blood pressure and less hardened arteries after one month of treatment, compared with those who did not take it. The small study was published in ‘Hypertension’, a journal of the American Heart Association.

High blood pressure and stiffness of the arteries contribute to the development of heart disease. People with T1D, a chronic, lifelong disease in which the pancreas does not produce enough insulin to control blood sugar levels, have a increased risk of developing heart disease compared to people who do not have the disease.

People with type 1 diabetes in childhood have a higher risk of heart disease than adults. Therefore, researchers are interested in finding ways to delay the onset of vascular disease in these children.

“We know that abnormalities in the great vessels that surround the heart, the aorta and its primary branches, begin to develop in childhood in people with type 1 diabetes,” said lead study author Dr. says Michael Schaefer, a researcher and fourth-year medical student University of Colorado School of Medicine (USA). We found that bromocriptine has the potential slow the development of those anomalies and reducing the risk of heart disease in this population.

bromocriptine effect

The multidisciplinary team conducted this study to investigate the effect of bromocriptine on blood pressure and aortic stiffness compared with placebo in adolescents with type 1 diabetes. Bromocriptine belongs to a class of drugs called dopamine receptor agonist.

It increases the level of dopamine, a chemical in the brain, which leads to an increase in the body’s response to insulin, which is called insulin sensitivity.

The study included 34 participants (13 males and 21 females) between the ages of 12 and 21 who had been diagnosed with type 1 diabetes for at least one year, and their HbA1c (glycosylated hemoglobin, a measure of blood glucose) was 12% or less. HbA1c levels greater than or equal to 6.5% indicate diabetes.

They were randomly divided into two groups of 17 people each, one given a rapid-release treatment of bromocriptine and the other a placebo once daily. The study was done in two phases. Participants took either the primary treatment or a placebo for 4 weeks in Phase 1, then no treatment for a 4-week “washout” period, followed by 4 weeks of the opposite treatment in Phase 2. In this “crossover” design, each participant served as their own control for comparison.

Blood pressure and aortic stiffness were measured at baseline and at the end of each phase. Aortic stiffness was determined by evaluating the great arteries with cardiac magnetic resonance imaging (MRI) and by pulse velocity measurements of blood pressure called pulse wave velocity.

The study found that compared to placeboSignificantly decreased blood pressure with bromocriptine. On average, treatment with bromocriptine resulted in a 5 mm Hg reduction in systolic blood pressure and a 2 mm Hg reduction in diastolic blood pressure at the end of 4 weeks of treatment.

Furthermore, aortic stiffness was also reduced with bromocriptine treatment. Improvement in aortic stiffness was most pronounced in the ascending aorta, with a decrease in pulse wave velocity of approximately 0.4 m/s and an increase in compliance, or elasticity, of 8%. In the thoraco-abdominal aorta, bromocriptine was associated with a decrease in pulse wave velocity of approximately 0.2 m/s with an increase in compliance of 5%.

“A stiffened aorta predisposes the patient to other health problems, such as organ dysfunction or atherosclerosis and increased stress or strain on the heart muscle,” Schaefer explains. “We were able to go a step further and show, using more sophisticated metrics, that these large central arteries are worse, and that damage among adolescents and young adults with type 1 diabetes could be slowed with this drug.”

Nation World News Desk
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