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- Title
Elastic Properties of Central Arteries in Type 1 Diabetic Patients Compared with Non-Diabetic Controls during Low and High Insulin Infusion.
- Authors
Forst, Senait; Wilhelm, Birgit; Pfützner, Andreas; Forst, Thomas
- Abstract
Insulin activity on vascular tissue is mediated by endothelial function and the release of NO. Recent studies supposed a direct effect of insulin on blood pressure augmentation, thereby modulating the elastic properties of central arteries. In our study we intended to compare the effect of different insulin concentrations on the elastic properties of central arterial compartments in type 1 diabetic patients compared to healthy controls. Thirteen patients with type 1 diabetes (age 36.6±11.8 years, diabetes 23.5±11.0 years, HbA1c 7.3±0.7%) and 13 non diabetic-controls (age 27.3±5.5 years) underwent two normo-glycaemic insulin clamp experiments with low (0.25 mU/kg/min) and high (1.0 mU/kg/min) insulin infusion in a randomised sequence. Arterial stiffness was measured using applanation tonometry at the radial artery (SphygnaoCor Vx, AtCor Medical, Australia). At baseline and after 60 and 120 minutes, pulse wave analysis was performed with the calculation of vascular augmentation pressure (AP) and the augmentation index (AIx). During the clamp procedure, the diabetic patients received less glucose compared with non-diabetic patients during low (Lo: 13.3±7.2 vs. 21.2±9.3 g, p=0.09) and during high glucose infusion (Hi: 49.2±30.8 vs. 74.9±22.0 g, p<0.05). At baseline, type 1 diabetic patients revealed a significant higher AP (3.5±3.1 vs. -0.7±2.6 mmHg; p<0.001) and AIx (12.5±12.9 vs. -4.2±10.6%, p<0.01). During high and low insulin infusion a slight improvement in vessel elasticity could be observed in the diabetic group, but it remained significantly reduced compared with the non-diabetic group (Lo: AP 2.1±3.5 vs. -0.1±1.9 mmHg, AIx 10.4±16.1 vs. -0.8±8.1%; Hi: AP 3.3±3.7 vs. -1.2±2.7 mmHg, AIx 10.2±12.2 vs. -4.4±11.6%; p<0.05 respectively). In our study, patients with type 1 diabetes mellitus revealed a reduction in insulin sensitivity, which was paralleled by impaired elastic properties of central arterial compartments. Despite insulin infusion slightly improved vascular stiffness in type 1 diabetic patients, it remained significantly worse compared with healthy controls. Further studies have to establish the link between insulin resistance and macrovascular complications even in type 1 diabetic patients.
- Subjects
INSULIN; BLOOD vessels; ARTERIES; BLOOD pressure; PEOPLE with diabetes; GLUCOSE; DIABETES; INSULIN resistance
- Publication
Diabetes, 2007, Vol 56, pA171
- ISSN
0012-1797
- Publication type
Article