Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction

You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.

WikiDoc Resources for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Articles
Most recent articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Most cited articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Review articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Images of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Photos of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Podcasts & MP3s on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Videos on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Evidence Based Medicine
Cochrane Collaboration on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Bandolier on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction TRIP on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Clinical Trials
Ongoing Trials on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction at Clinical Trials.gov Trial results on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Clinical Trials on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction NICE Guidance on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction NHS PRODIGY Guidance FDA on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction CDC on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Books
Books on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
News
Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in the news Be alerted to news on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction News trends on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Commentary
Blogs on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Definitions
Definitions of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Patient Resources / Community
Patient resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Discussion groups on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Patient Handouts on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Directions to Hospitals Treating Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Risk calculators and risk factors for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Healthcare Provider Resources
Symptoms of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Causes & Risk Factors for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Diagnostic studies for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction Treatment of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Continuing Medical Education (CME)
CME Programs on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
International
Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction en Espanol Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction en Francais
Businness
Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in the Marketplace Patents on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Experimental / Informatics
List of terms related to Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction

May 29, 2008 By Vijayalakshmi Kunadian MBBS MD MRCP [1]

JACC: A new study suggests that consumption of flavanol-containing cocoa drinks reverses vascular dysfunction among diabetic patients.

Endothelial dysfunction is a major determinant of atherosclerosis and has been demonstrated to be associated with adverse cardiovascular outcomes among diabetic patients with cardiovascular risk factors and among those with established cardiovascular diseases. Previous studies have suggested beneficial effects of flavanol-containing cocoa products on platelet aggregation, insulin sensitivity, endothelial function, blood pressure and low density lipoprotein oxidation and have been correlated with mortality due to cardiovascular disease ^[1] and diabetes mellitus. Fruit, vegetables, tea, red wine, cocoa and cocoa products are rich in flavanols. Nitric oxide (NO) is essential factor for endothelial function which can be measured by flow-mediated dilation (FMD). Although the exact mechanism of the beneficial effect of flavanols is unclear, flavanols have been speculated to work by an increase in the NO synthase activity.

A new study by Balzer and co-workers published in the latest issue of the Journal of the American College of Cardiology [see link below] determined the longer-term (30 days) effects of flavanol-containing cocoa on vascular function among diabetic patients. The investigators conducted a feasibility study consisting of 10 patients and an efficacy study consisting of 41 patients. Both studies were randomized, double-blinded and controlled. Patients aged 50-80 years with stable type 2 diabetes mellitus for at least 5 years were included in the study. Those in the feasibility study consumed a cocoa drink (Hackettstown, New Jersey) that provided 3 doses of flavanols (control: 75 mg flavanol, medium: 371 mg flavanol, and high: 963 mg of flavanol). In the efficacy study 2 doses of flavanols were administered for 30 days (treatment group: 321 mg flavanol/dose, 3 doses/day and the control group: 25 mg flavanol/dose, 3 doses/day). FMD of the brachial artery, plasma flavanol metabolites, arterial blood pressure, and heart rate were measured in the 2 studies at regular intervals.

In the feasibility study, there was a significant increase in the FMD at 2 hours following ingestion of the highest dose flavanol (963 mg) compared with baseline FMD values (5.5±0.4% vs. 3.8±0.3%, p<0.001) and plasma flavanol concentration.

In the efficacy study, daily intake of flavanol-containing drink resulted in a continual increase in the FMD from 3.3±1.1% at baseline, to 4.1±1.1% at day 8 and 4.3±1.2% at day 30, p<0.0001. There was no evidence of desensitization and tachyphylaxis (drug tolerance). No difference in the FMD was observed among those who received sublingual nitrate between the treatment and the study groups. Significant rise in the plasma flavanol levels was observed among those who consumed the highest dose of flavanol-containing drink (p<0.01). Blood pressure, heart rate and glycemic control were unaffected. No side effects were observed during the entire duration of the study.

The investigators provide 4 main conclusions for their study in diabetic patients:

• Flavanols are absorbed in a dose dependent fashion
• Regular daily ingestion of flavanol-containing cocoa reverses vascular function
• Vasodilation using GTN is unaffected by flavanol consumption
• Consumption of flavanol was well tolerated without major adverse effects.

This study along with previous studies underscores the importance of dietary intervention in the management of patients with diabetes and provides insight to the treatment of vascular dysfunction. Further research to determine the impact of flavanol-containing drinks on clinical outcomes among diabetic patients with cardiovascular disease would be worthwhile.

Source

http://content.onlinejacc.org/cgi/content/abstract/51/22/2141

Reference

v • d • e WikiDoc Research Resources for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction (Click show to right to view)
Articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Most recent articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Most cited articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Review articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Articles on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Powerpoint slides on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Images of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Photos of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Podcasts & MP3s on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Videos on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Evidence Based Medicine Regarding Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Cochrane Collaboration on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Bandolier on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • TRIP on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Cost Effectiveness of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Cost Effectiveness of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Clinical Trials Involving Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Ongoing Trials on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction at Clinical Trials.gov • Trial results on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Clinical Trials on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	US National Guidelines Clearinghouse on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • NICE Guidance on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • NHS PRODIGY Guidance • FDA on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • CDC on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Textbook Information on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Books and Textbook Information on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Pharmacology Resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Dosing of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Drug interactions with Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Side effects of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Allergic reactions to Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Overdose information on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Carcinogenicity information on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in pregnancy • Pharmacokinetics of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction •
Genetics, Pharmacogenomics, and Proteinomics of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Genetics of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Pharmacogenomics of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Proteomics of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Newstories on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in the news • Be alerted to news on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • News trends on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Commentary on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Blogs on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Patient Resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Patient resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Discussion groups on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Patient Handouts on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Directions to Hospitals Treating Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Risk calculators and risk factors for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Healthcare Provider Resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Symptoms of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Causes & Risk Factors for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Diagnostic studies for Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction • Treatment of Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Continuing Medical Education (CME) Programs on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	CME Programs on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
International Resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction en Espanol • Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction en Francais
Business Resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction in the Marketplace • Patents on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction
Informatics Resources on Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction	List of terms related to Cocoa Containing Flavanols might be Beneficial in Diabetic Patients with Vascular Dysfunction

WikiDoc Help Menu Quick Start.. Get Started Here! How to Login How to Search Pages How to Start a New Page How to Edit a Page Cheat Sheet Editing basics Learning Basic Formatting How to make Links in WikiDoc & to External Sites How to Make Lists How to Ignoring Formatting Adding References or Footnotes to Articles Tracking Changes You Have Made How to Put an Article Into a Category When Multiple Topics Should Go To The Same Page (MI, Acute MI, AMI) Using Redirection Advanced editing How to Make Tables How to Insert Images and Other Media How to Add Video Help:How to Make Columns Web Colors How To Make Templates How to Move Pages Inserting Dynamic Dates and Times Inserting WikiDoc Statistics Editing the Table of Contents Communicating your edits Let others know what you changed: The importance of Edit Summaries Minor Edits Edit Conflicts Help Videos You Can Watch Getting Started Video

Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .