Col and only baseline MR examinations were performed in this subgroup of patients. During the course of the study no adjustments of lipid lowering and/or anti-hypertensive medication were performed. During the first 10 days of the inpatient setting standardized frequent measurements of blood glucose concentrations (0 h, 3 h, 6 h, 9 h, 12 h, 15 h, 18 h, 21 h; Accu-Check Go Blood Glucose Monitor, Roche Diagnostics, Vienna, Austria) allowed to quickly titrate insulin doses and achieve pre-prandial glucose concentrations of 100?20 mg/dl. Insulin doses were adjusted twice daily by experienced physicians. In addition a standardized diet with 1400 kilocalories per day (fat/carbohydrate/protein: 32 /48 /20 ) was administered during inpatient treatment. All patients were advised to adhere to the diet plan after the discharge. Furthermore, structured inpatient diabetes training included recommendations for regular moderate physical activity. Ten days after the initiation of IT MRI and MRS studies were repeated. Patients were discharged on day 10. Clinical and MR follow up examinations were performed in 7 patients 181649 days after initiation of IT.Study ParticipantsEighteen patients with T2DM were recruited from the outpatient service of our department (Table 1). Inclusion criteria were insufficient metabolic control under oral anti-diabetic medication at the time point of clinical assessment (HbA1c .8 ) and resting blood pressure ,150/85 mmHg with or without antihypertensive medication. Patients with previous myocardial infarction, coronary artery disease and/or history of congestive heart failure were excluded. In addition, subjects, who received digitalis and/or thioazolidinediones did not participate, since thiazolidinediones have been shown to affect myocardial lipid content [15]. None of the study participants had been treated with insulin before or presented with type 1 diabetes-related antibodies. All female patients were postmenopausal. Oral antidiabetic agents prior the initiation of IT included: metformin (n = 13), sulfonylurea or glinide (n = 8), and gliptine (n = 5). Eleven study participants were on lipid lowering therapy with statins and 1 was treated with ezetimibe. Eight patients reported regular intake of combined anti-hypertensive therapy (angiotensin 2 receptor antagonist or ACE inhibitor: n = 3; selective b-blocker: n = 1; calcium channel blocker: n = 1; diuretics: n = 1).Magnetic Resonance Imaging (MRI) and ITI-007 biological activity Spectroscopy (MRS)All magnetic resonance measurements were performed on a 3.0-T Tim Trio System (Siemens Helathcare, 1516647 Erlangen, Germany) operated with the Syngo VB15 and VB17 user interface. 1 H-MRI for myocardial function. Visualization of cardiac function was performed employing retrospective ECG-gated cine true fast imaging with steady-state precession (TrueFISP) sequences in 2-chamber, 4-chamber and short axes orientation. Short axes images were used to quantify left ventricular Lecirelin custom synthesis global function (enddiastolic and end-systolic volume, stroke volume, ejection fraction and myocardial mass) after manual demarcation of endo- and epicardial borders in end-systolic and end-diastolic phase via ARGUS software (Siemens Healthcare, Erlangen, Germany). Papillary muscles and trabecles were counted to the lumen of the left ventricle. Myocardial mass was determined as mean of enddiastolic and end-systolic muscle volume multiplied with a density of 1.05 g/cm3. Mid-ventricular short axis slices were analyzed for the assessment of left v.Col and only baseline MR examinations were performed in this subgroup of patients. During the course of the study no adjustments of lipid lowering and/or anti-hypertensive medication were performed. During the first 10 days of the inpatient setting standardized frequent measurements of blood glucose concentrations (0 h, 3 h, 6 h, 9 h, 12 h, 15 h, 18 h, 21 h; Accu-Check Go Blood Glucose Monitor, Roche Diagnostics, Vienna, Austria) allowed to quickly titrate insulin doses and achieve pre-prandial glucose concentrations of 100?20 mg/dl. Insulin doses were adjusted twice daily by experienced physicians. In addition a standardized diet with 1400 kilocalories per day (fat/carbohydrate/protein: 32 /48 /20 ) was administered during inpatient treatment. All patients were advised to adhere to the diet plan after the discharge. Furthermore, structured inpatient diabetes training included recommendations for regular moderate physical activity. Ten days after the initiation of IT MRI and MRS studies were repeated. Patients were discharged on day 10. Clinical and MR follow up examinations were performed in 7 patients 181649 days after initiation of IT.Study ParticipantsEighteen patients with T2DM were recruited from the outpatient service of our department (Table 1). Inclusion criteria were insufficient metabolic control under oral anti-diabetic medication at the time point of clinical assessment (HbA1c .8 ) and resting blood pressure ,150/85 mmHg with or without antihypertensive medication. Patients with previous myocardial infarction, coronary artery disease and/or history of congestive heart failure were excluded. In addition, subjects, who received digitalis and/or thioazolidinediones did not participate, since thiazolidinediones have been shown to affect myocardial lipid content [15]. None of the study participants had been treated with insulin before or presented with type 1 diabetes-related antibodies. All female patients were postmenopausal. Oral antidiabetic agents prior the initiation of IT included: metformin (n = 13), sulfonylurea or glinide (n = 8), and gliptine (n = 5). Eleven study participants were on lipid lowering therapy with statins and 1 was treated with ezetimibe. Eight patients reported regular intake of combined anti-hypertensive therapy (angiotensin 2 receptor antagonist or ACE inhibitor: n = 3; selective b-blocker: n = 1; calcium channel blocker: n = 1; diuretics: n = 1).Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS)All magnetic resonance measurements were performed on a 3.0-T Tim Trio System (Siemens Helathcare, 1516647 Erlangen, Germany) operated with the Syngo VB15 and VB17 user interface. 1 H-MRI for myocardial function. Visualization of cardiac function was performed employing retrospective ECG-gated cine true fast imaging with steady-state precession (TrueFISP) sequences in 2-chamber, 4-chamber and short axes orientation. Short axes images were used to quantify left ventricular global function (enddiastolic and end-systolic volume, stroke volume, ejection fraction and myocardial mass) after manual demarcation of endo- and epicardial borders in end-systolic and end-diastolic phase via ARGUS software (Siemens Healthcare, Erlangen, Germany). Papillary muscles and trabecles were counted to the lumen of the left ventricle. Myocardial mass was determined as mean of enddiastolic and end-systolic muscle volume multiplied with a density of 1.05 g/cm3. Mid-ventricular short axis slices were analyzed for the assessment of left v.
