Impaired vasoconstriction of peripheral cutaneous blood flow in Type 1 diabetic patients following food ingestion.
Abnormalities in cutaneous blood flow (CBF) in otherwise healthy subjects with Type 1 diabetes mellitus (DM) have been demonstrated in response to local insults to the skin. To investigate whether defects also occurred in response to a regular daily activity, CBF was measured with laser Doppler flowmetry (LDF), before and 20 min after starting a mixed meal in 13 male Type 1 DM subjects with no clinical evidence of neuropathy, nephropathy or macroangiopathy and compared to 7 non-diabetic controls. Diabetic subjects and controls were of similar age and body mass index (mean +/- SD, 33.7 +/- 7.4 vs 37.1 +/- 9.2 years and 25.2 +/- 2.9 vs 24.5 +/- 2.9 kg m(-2), respectively). In subjects with DM, HbA1c was 8.3 +/- 0.6% (normal range 4-5.5%) and duration of diabetes was 18 (8-38) years, median (range). Following a mixed meal the CBF fell in the controls by 36% (24 to 56), median (range), compared to 3% (-5 to 18) in Type 1 DM subjects, P < 0.0005. These results show there is a normal physiological fall in CBF following food ingestion which is attenuated in Type 1 DM. These abnormalities of vasoconstriction in the peripheral microcirculation are present after 8 years of diabetes and precede the development of clinically apparent neuropathy or vascular disease.
Rossi
M
M
Department of Endocrinology, Imperial College School of Medicine, The Hammersmith Hospital, London, UK.
Lall
K
K
Standfield
N
N
Dornhorst
A
A
D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D004435:Eating / Q000502:physiology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D014661:Vasoconstriction / Q000502:physiology*