The postprandial state does not impair endothelial function in women with type 2 diabetes irrespective of glycaemic control.
OBJECTIVE
The postprandial state has been shown to be associated with endothelial dysfunction, a predictor of cardiovascular morbidity. In type 2 diabetes, postprandial metabolic excursions are prolonged and exaggerated, but less pronounced if glycaemic control is optimised. We investigated the impact of improved glycaemic control on endothelial function in the postprandial state.


METHODS
We studied 19 postmenopausal women with type 2 diabetes and ten non-diabetic subjects. Participants with diabetes were re-studied 3 months after intensive glucose regulation. We measured forearm blood flow by strain gauge plethysmography during rest, during acetylcholine infusion and post ischaemia in the fasting state, and again 3 hours after a mixed meal (660 kcal, 55% fat).


RESULTS
Endothelium-dependent vasodilation was impaired in the diabetic group (p<0.005) and improved following an HbA1c reduction of 0.96% (p<0.05 for high-dose acetylcholine infusion). Postprandial metabolic excursions were higher in the diabetic group (p<0.001, p<0.01 and p<0.05 for glucose, insulin and triglycerides respectively). Resting forearm blood flow increased in all groups after the meal (p<0.005). There was no difference in fasting and postprandial endothelium-dependent vasodilation before and after improved glucose regulation in either group.


CONCLUSIONS
The postprandial state does not impair endothelial function in non-diabetic women and does not make pre-existing endothelial dysfunction worse in women with type 2 diabetes, irrespective of glycaemic control.
Strey
C H
CH
Lipid and Diabetes Research Group, Hagley Building, Christchurch Hospital, Christchurch, New Zealand.
Young
J
J
Collier
M
M
Florkowski
C M
CM
Shand
B I
BI
Scott
R S
RS
D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005542:Forearm / Q000098:blood supply; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010991:Plethysmography; D017698:Postmenopause; D019518:Postprandial Period; D012907:Smoking
D007004:Hypoglycemic Agents; D005640:Follicle Stimulating Hormone