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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.

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



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.


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


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).


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.


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).


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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