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Clin Endocrinol (Oxf). 2012 Jun;76(6):825-30. doi: 10.1111/j.1365-2265.2011.04211.x.

Increases in muscle blood flow after a mixed meal are impaired at all stages of type 2 diabetes.

Author information

1
2nd Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, Athens University Medical School, Athens, Greece.

Abstract

OBJECTIVE:

In type 2 diabetes, although the impairment of postprandial muscle blood flow response is well established, information on the effect of this impairment on glucose uptake and lipid metabolism is controversial.

DESIGN:

Postprandial forearm blood flow responses and metabolic parameters were assessed in a cross-sectional study of subjects at various stages of insulin resistance.

PATIENTS:

Eleven healthy subjects (CONTROLS), 11 first-degree relatives of type-2 diabetics (RELATIVES), 10 patients with impaired glucose tolerance (IGT), 10 diabetic patients with postprandial hyperglycaemia (DMA), and 13 diabetic patients with both fasting and postprandial hyperglycaemia (DMB).

MEASUREMENTS:

All subjects received a meal. Blood was drawn from a forearm deep vein and the radial artery at specific time-points during a period of 360 min for measurements of glucose, insulin, triglycerides and nonesterified-fatty acids. Forearm muscle blood flow was measured with strain-gauge plethysmography. Glucose uptake and ISI Index were calculated.

RESULTS:

Peak-baseline muscle blood flow was higher in CONTROLS (3.32 ± 0.4) than in RELATIVES (0.53 ± 0.29), IGT (0.82 ± 0.2), DMA (1.44 ± 0.34), DMB (1.23 ± 0.35 ml/min/100 ml tissue), P < 0.001. Glucose uptake (AUC(0-360,) μmol/100 ml tissue) was higher in CONTROLS (1023 ± 132) than in RELATIVES (488 ± 42), IGT (458 ± 43), DMA (347 ± 63), DMB (543 ± 53), P < 0.001. ISI index, postprandial triglycerides and nonesterified-fatty acids behaved in a similar way. Peak-baseline muscle blood flow correlated positively with glucose uptake (r = 0.440, P = 0.001) and ISI index (r = 0.397, P = 0.003), and negatively with postprandial triglycerides (r = -0.434, P = 0.001) and nonesterified-fatty acids (r = -0.370, P = 0.005).

CONCLUSIONS:

These results suggest that increase in muscle blood flow after a meal is impaired at all stages of type-2 diabetes. This defect influences glucose uptake and is associated with impaired lipid metabolism in the postprandial state.

[Indexed for MEDLINE]

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