title: Decreased circulatory response to hypovolemic stress in young women with type 1 diabetes.
abstract: OBJECTIVE
  Diabetes is associated with hemodynamic instability during different situations involving acute circulatory stress in daily life. Young men with type 1 diabetes have been shown to have impaired circulatory response to hypovolemic stress. The effect of type 1 diabetes on cardiovascular response to hypovolemia in young women is unknown, however.
  
  
  METHODS
  Lower body negative pressure of 30 cm H2O was used to create rapid hypovolemic stress in 15 young women with type 1 diabetes (DW) and 16 healthy women (control subjects [C]). Compensatory mobilization of venous capacitance blood (capacitance response) and net fluid absorption from tissue to blood were measured with a volumetric technique. Overall cardiovascular responses and plasma norepinephrine levels were measured.
  
  
  RESULTS
  Capacitance response was reduced (DW, 0.67 ± 0.05; C, 0.92 ± 0.06) and developed slower in DW (P < 0.01). Capacitance response was further reduced with increasing levels of HbA1c. Fluid absorption was almost halved in DW (P < 0.01). The initial vasoconstrictor response was reduced and developed slower in DW (P < 0.05). Arterial vasoconstriction was further reduced in the presence of microvascular complications (P < 0.05).
  
  
  CONCLUSIONS
  DW present with decreased and slower mobilization of venous capacitance blood and decreased net fluid absorption from tissue to blood during hypovolemic circulatory stress. Collectively, this indicates that DW are prone to hemodynamic instability, especially in the presence of microvascular complications and poor glycemic control.
authors.affiliation: Corresponding author: Marcus Lindenberger, marcus.lindenberger@liu.se.
authors.forename: Marcus
authors.initials: M
authors.lastname: Lindenberger
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Lindström
authors.forename: Toste
authors.initials: T
authors.lastname: Länne
mesh_terms: D000293:Adolescent; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D020896:Hypovolemia / Q000209:etiology / Q000503:physiopathology*; D008150:Lower Body Negative Pressure / Q000009:adverse effects*; D008297:Male; D055815:Young Adult