Impaired cutaneous reactive hyperaemia during hypoglycaemia in young insulin-dependent diabetic patients and healthy controls.
The aim of the present study was to compare the cutaneous postischaemic hyperaemic response in young insulin-dependent diabetic patients and healthy subjects during normoglycaemia, acute insulin-induced hypoglycaemia and in the posthypoglycaemic state. After a night of normoglycaemia the cutaneous postischaemic hyperaemic response in the forearm skin, measured by the transcutaneous PO2 method, was the same in both groups. A reduction of the maximal postischaemic vasodilatory response was observed in diabetic patients from 2.4 +/- 0.3 to 2.0 +/- 0.2 kPa (P less than 0.05) and in control subjects from 2.7 +/- 0.3 to 1.8 +/- 0.2 kPa (P less than 0.02) during insulin-induced hypoglycaemia (plasma glucose less than 2 mmol/l). Complete recovery of the vasodilatory response occurred in subjects in the posthypoglycaemic state. We conclude that hypoglycaemia induced a transient reduction of the vasodilatory response, which was rapidly reversed after glucose counter-regulation, in both diabetic patients and healthy controls. Thus, the prevailing blood glucose concentration must be taken into account when the postischaemic vasodilatory response is investigated in diabetic patients.
Aman
J
J
Department of Paediatrics, University Hospital, Uppsala, Sweden.
Berne
C
C
Ewald
U
U
Tuvemo
T
T
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D004837:Epinephrine / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D007003:Hypoglycemia / Q000139:chemically induced / Q000503:physiopathology*; D007328:Insulin / Q000494:pharmacology* / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D007511:Ischemia / Q000503:physiopathology; D008297:Male; D009638:Norepinephrine / Q000097:blood; D012016:Reference Values; D012039:Regional Blood Flow / Q000187:drug effects; D012867:Skin / Q000098:blood supply*; D014664:Vasodilation
D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon; D009638:Norepinephrine; D004837:Epinephrine