The effect of rosiglitazone on orthostatic tolerance during heat exposure in individuals with type II diabetes.
METHODS
Twenty-two subjects with type II diabetes and 30 control subjects participated in a 1-year study to examine the effect of rosiglitazone on heart rate variability at rest and the blood pressure, heart rate, and blood flow changes during a change in body position from horizontal to the 45 degrees head up position. To assess nerve damage, latency was measured for sensory nerves in the foot.


RESULTS
The results of the experiments showed that subjects with diabetes had an approximate 50% impairment in sural, medial, and lateral plantar nerve latency. After 1 year of administration of rosiglitazone, there was improvement by about 50% in sural, medial, and lateral nerve plantar latency. The changes in blood flow in the subject with diabetes was less than half that of control subjects, during tilting from the horizontal to the vertical position. Heart rate variability was less during tilt, and the blood pressure change was significantly greater in subjects with diabetes than control subjects (P < 0.01). After administration of rosiglitazone for 1 year, the changes in blood flow, blood pressure, and heart rate, while improving by about half, were not equal to those of age matched controls (P < 0.01).


CONCLUSIONS
The results of the experiments indicate that the insulin sensitizer rosiglitazone cannot reverse all of the damage associated with diabetes to the autonomic nervous system, but much can be reversed.
Petrofsky
Jerrold
J
Department of Physical Therapy, Loma Linda University, Loma Linda, California. jerry-petrofsky@sahp.llu.edu
Lee
Scott
S
Cuneo-Libarona
Maria
M
Apodaca
Patricia
P
D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006358:Hot Temperature; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007024:Hypotension, Orthostatic / Q000503:physiopathology*; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D011187:Posture; D012016:Reference Values; D000077154:Rosiglitazone; D012867:Skin / Q000098:blood supply; D045162:Thiazolidinediones / Q000627:therapeutic use*
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000077154:Rosiglitazone; D045162:Thiazolidinediones