Document Detail

Vessel wall stiffness in type 1 diabetes and the central hemodynamic effects of acute hypoglycemia.
MedLine Citation:
PMID:  17726149     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the effects of intravenous insulin and acute hypoglycemia on arterial wall stiffness and central hemodynamic responses in adults with and without type 1 diabetes.
RESEARCH DESIGN AND METHODS: In 30 young male volunteers [10 nondiabetic (Group 1); 10 with type 1 diabetes, <5 yr duration (Group 2); 10 with type 1 diabetes, >15 yr duration (Group 3)], intravenous insulin was administered to provoke an acute autonomic reaction (R) to hypoglycemia. Heart rate, peripheral blood pressure, and pulse wave analysis (radial artery) were monitored. Augmentation index (AIx), a measure of arterial wall stiffness and wave reflection, and central arterial pressure were recorded.
RESULTS: At baseline, no significant differences were observed between Groups 1 and 2 in either AIx or in central arterial pressure, but in Group 3, both measures were significantly higher. All three groups exhibited similar responses to intravenous infusion of insulin and to hypoglycemia: AIx fell progressively from baseline to R, peripheral systolic blood pressure increased, and central systolic pressure decreased.
CONCLUSION: Compared with age- and sex-matched nondiabetic controls, people who had type 1 diabetes for a long duration had increased stiffness of vessel walls. The opposing responses in peripheral and central systolic pressures during hypoglycemia may be related to the reduction in AIx, which causes diminished amplification of the systolic pressure wave. Changes in AIx are probably mediated by a direct action of insulin on arterial endothelium, or changes in heart rate. These functional changes may contribute to the increased cardiovascular morbidity that is associated with type 1 diabetes of long duration.
Andrew J Sommerfield; Ian B Wilkinson; David J Webb; Brian M Frier
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-28
Journal Detail:
Title:  American journal of physiology. Endocrinology and metabolism     Volume:  293     ISSN:  0193-1849     ISO Abbreviation:  Am. J. Physiol. Endocrinol. Metab.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-08     Completed Date:  2007-12-18     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  100901226     Medline TA:  Am J Physiol Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1274-9     Citation Subset:  IM    
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MeSH Terms
Autonomic Nervous System / physiopathology
Blood Glucose / metabolism
Blood Pressure / physiology
Diabetes Mellitus, Type 1 / blood,  physiopathology*
Heart Rate / physiology
Hemodynamics / physiology
Hypoglycemia / blood,  physiopathology*
Insulin / physiology*
Radial Artery / physiopathology*
Grant Support
FS/07/001/21990//British Heart Foundation
Reg. No./Substance:
0/Blood Glucose; 0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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