Int J Stem Cells.  2016 May;9(1):137-144. 10.15283/ijsc.2016.9.1.137.

Severe Type 2 Diabetes Induces Reversible Modifications of Endothelial Progenitor Cells Which are Ameliorate by Glycemic Control

  • 1U.O.C. Division of Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, Azienda Ospedaliera Universitaria (AOU), Second University of Naples, Naples, Italy. maria.depascale@policliniconapoli.
  • 2Division of Cardiology, ASL NA1, Pellegrini Hospital, Naples, Italy.
  • 3Department of Anesthesia and Critical Care Medicine, University of Florida, Shands Hospital, Florida, USA.
  • 4Department of Medicine and Surgery, Plastic Surgery Unit, University of Salerno, Salerno, Italy.
  • 5Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, Second University of Naples, Naples, Italy.
  • 6IRCCS Foundation SDN, Naples, Italy.
  • 7Geriatrics Medicine, Department of Translational Medical Science, Federico II University of Naples, Naples, Italy.


Circulating endothelial progenitors cells (EPCs) play a critical role in neovascularization and endothelial repair. There is a growing evidence that hyperglycemia related to Diabetes Mellitus (DM) decreases EPC number and function so promoting vascular complications. AIM OF THE STUDY: This study investigated whether an intensive glycemic control regimen in Type 2 DM can increase the number of EPCs and restores their function.
Sixty-two patients with Type 2 DM were studied. Patients were tested at baseline and after 3 months of an intensive regimen of glycemic control. The Type 2 DM group was compared to control group of subjects without diabetes. Patients with Type 2 DM (mean age 58.2±5.4 years, 25.6% women, disease duration of 15.4±6.3 years) had a baseline HgA1c of 8.7±0.5% and lower EPC levels (CD34+/KDR+) in comparison to healthy controls (p<0.01).
The intensive glycemic control regimen (HgA1c decreased to 6.2±0.3%) was coupled with a significant increase of EPC levels (mean of 18%, p<0.04 vs. baseline) and number of EPCs CFUs (p<0.05 vs. baseline).
This study confirms that number and bioactivity of EPCs are reduced in patients with Type 2 DM and, most importantly, that the intensive glycemic control in Type 2 DM promotes EPC improvement both in their number and in bioactivity.


Type 2 diabetes; Endothelial progenitor cells; Vascular disease; Regenerative medicine

MeSH Terms

Diabetes Mellitus
Regenerative Medicine
Stem Cells*
Vascular Diseases
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