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Diabetes Res Clin Pract. 2014 Dec;106(3):617-26. doi: 10.1016/j.diabres.2014.09.044. Epub 2014 Oct 7.

Uncomplicated human type 2 diabetes is associated with meal-induced blood pressure lowering and cardiac output increase.

Author information

1
Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: mm.smits1@vumc.nl.
2
Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
3
Department of Systems Physiology, Academic Medical Center, Amsterdam, The Netherlands.

Abstract

AIMS:

Since many type 2 diabetes patients experience postprandial hypotension, the aim of this study was to unravel meal-related changes in systemic hemodynamics and autonomic nervous system (ANS)-balance.

METHODS:

Forty-two age-matched males (15 type 2 diabetes; 12 metabolic syndrome; 15 controls) without overt autonomic neuropathy received a standardized high-fat mixed meal after an overnight fast. Hemodynamic variables were measured by finger plethysmography. Fourier analysis was used to calculate the low-/high-frequency (LF/HF)-ratio, a marker of autonomic nervous system-balance, and baroreceptor reflex sensitivity (BRS).

RESULTS:

Following the meal, diastolic blood pressure (DBP) decreased in type 2 diabetes patients only, paralleled by a significant decrement in systemic vascular resistance (SVR) and an increase in cardiac index. All groups showed an increase in postprandial heart rate. Controls, but not metabolic syndrome or type 2 diabetes patients, showed a meal-related increase in LF/HF-ratio. When combining all study subjects, homeostatic model assessment-insulin resistance (HOMA-IR) was inversely correlated with changes in DBP, SVR, LF/HF-ratio and BRS.

CONCLUSIONS:

Based on these data, we hypothesize that in patients with uncomplicated type 2 diabetes, insulin resistance hampers adequate meal-induced sympathetic activation, leading to a decrease in SVR and resulting in a postprandial drop in DBP.

KEYWORDS:

Autonomic nervous system; Metabolic syndrome; Postprandial hemodynamics; Type 2 diabetes

PMID:
25458327
DOI:
10.1016/j.diabres.2014.09.044
[Indexed for MEDLINE]

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