Clinical trial NCT05946785: Oxidative Stress in Microvascular Dysfunction Following Gestational Diabetes
Official title: Role of Oxidative Stress in Microvascular Dysfunction Following Gestational Diabetes
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: EARLY_PHASE1
Conditions: Gestational Diabetes
Vascular Endothelial Function
Keywords: gestational diabetes
postpartum
vascular
Lead sponsor: University of Iowa
Sponsor class: OTHER
First posted: 2023-07-14
Enrollment: 28
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: BASIC_SCIENCE

Brief summary: The purpose of this investigation is to examine the role of oxidative stress in aberrant microvascular function in otherwise healthy women with a history of GDM.

Detailed description: Women with a history of gestational diabetes mellitus (GDM) are at a 2-fold greater risk for the development of overt cardiovascular disease (CVD) following the effected pregnancy. While subsequent development of type II diabetes elevates this risk, prior GDM is an independent risk factor for CVD morbidity, particularly within the first decade postpartum. GDM is associated with impaired endothelial function during pregnancy and decrements in macro- and microvascular function persist postpartum, despite the remission of insulin resistance following delivery. Collectively, while the association between GDM and elevated lifetime CVD risk is clear, and available evidence demonstrates a link between GDM and vascular dysfunction in the decade following pregnancy, the mechanisms mediating this persistent dysfunction remain unexamined.

The purpose of this investigation is to examine the role of oxidative stress in mediating vascular dysfunction in women who have had gestational diabetes.

In this study, the investigators use the blood vessels in the skin as a representative vascular bed for examining mechanisms of microvascular dysfunction in humans. Using a minimally invasive technique (intradermal microdialysis for the local delivery of pharmaceutical agents) they examine the blood vessels in a dime-sized area of the skin in women who have had GDM. As a compliment to these measures, the investigators also collect endothelial cells from an antecubital vein and measure markers of oxidative stress and insulin-mediated eNOS phosphorylation in these cells.

Eligibility criteria: INCLUSION CRITERIA:

* female sex
* 18 -50 years old
* pregnancy history within 5 years of the study visit
* had gestational diabetes diagnosed by their obstetrician and confirmed according to the American College of Obstetricians and Gynecologists criteria for gestational diabetes
* or without a history of gestational diabetes

EXCLUSION CRITERIA:

* skin diseases
* current tobacco/e-cigarette use
* diagnosed or suspected hepatic or metabolic disease including diabetes
* statin or other cholesterol-lowering medication
* current antihypertensive medication
* history of preeclampsia or gestational hypertension
* current pregnancy
* body mass index \<18.5 kg/m2
* allergy to materials used during the experiment.(e.g. latex), known allergies to study drugs.

Primary outcomes:
measure: microvascular acetylcholine-mediated dilation
timeFrame: at the study visit, an average of 4 hours
measure: microvascular insulin-mediated dilation
timeFrame: at the study visit, an average of 4 hours
Secondary outcomes:
measure: endothelial cell markers of oxidative stress
timeFrame: at the study visit, an average of 4 hours
measure: endothelial cell insulin-stimulated eNOS phosphorylation
timeFrame: at the study visit, an average of 4 hours
Other outcomes:
Locations:
city: Iowa City
country: United States
facility: University of Iowa
state: Iowa
Study officials:
References: