Acute Hyperglycemia and Hyperinsulinemia Enhance Vasodilatation in Type 1 Diabetes Mellitus without Increasing Capillary Permeability and Inducing Endothelial Dysfunction

Uncomplicated Type 1 (insulin-dependent) diabetes mellitus is characterized by generalized vasodilatation. Its possible correlates, increased microvascular permeability and endothelial dysfunction, have been associated with long-term complications. The objective was to study the effects of acute hyp...

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Published in:	Microvascular research Vol. 63; no. 1; pp. 1 - 9
Main Authors:	Oomen, P.H.N., Kant, G.D., Dullaart, R.P.F., Reitsma, W.D., Smit, A.J.
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Inc 01-01-2002 Elsevier
Subjects:	Acute Disease Adult Associated diseases and complications Biological and medical sciences Capillaries - pathology Capillary Permeability capillary recruitment diabetes Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - metabolism Diabetes. Impaired glucose tolerance Dose-Response Relationship, Drug Endocrine pancreas. Apud cells (diseases) Endocrinopathies endothelium Endothelium, Vascular - metabolism Endothelium, Vascular - pathology Female Humans hyperglycemia Hyperglycemia - complications Hyperglycemia - metabolism hyperinsulinemia Hyperinsulinism - complications Hyperinsulinism - metabolism intercellular adhesion molecule-1 Intercellular Adhesion Molecule-1 - biosynthesis Male Medical sciences Sodium Fluoride - metabolism Time Factors Vasodilation von Willebrand factor von Willebrand Factor - biosynthesis hyperglycemia endothelium hyperinsulinemia von Willebrand factor capillary permeability diabetes capillary recruitment intercellular adhesion molecule-1 Endocrinopathy Human Immunopathology Hyperinsulinemia Pancreatic hormone Endothelial cell Cell permeability Autoimmune disease Glucose tolerance test Glucose Insulin Long term Vasodilation Vasomotricity Dysfunction Insulin dependent diabetes Complication Carbohydrate Blood capillary Circulatory system
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Summary:	Uncomplicated Type 1 (insulin-dependent) diabetes mellitus is characterized by generalized vasodilatation. Its possible correlates, increased microvascular permeability and endothelial dysfunction, have been associated with long-term complications. The objective was to study the effects of acute hyperglycemia and hyperinsulinemia, both separately and in combination, on skin microvascular flow, capillary permeability, capillary recruitment, and endothelial dysfunction in Type 1 diabetes mellitus. Sixteen Type 1 diabetic patients (all normoalbuminuric, no (pre-)proliferative retinopathy) underwent a euglycemic (glucose target 5.0 mmol/L, insulin infused at 30 mU · kg−1 · h−1), a hyperglycemic (glucose target 12.0 mmol/L, insulin 30 mU · kg−1 · h−1), a hyperinsulinemic (glucose target 5.0 mmol/L, insulin 150 mU · kg−1 · h−1), and a hyperglycemic–hyperinsulinemic (glucose target 12.0 mmol/L, insulin 150 mU · kg−1 · h−1) clamp on separate days, in random order. Skin microvascular flow was measured by laser Doppler flowmetry. Capillary permeability and density were determined by large-window sodium-fluorescein videodensitometry. Increases in serum soluble intercellular adhesion molecule-1 (sICAM-1) and plasma von Willebrand factor antigen (vWF-Ag) were considered to represent abnormal endothelial function. Hyperglycemia (P < 0.01) and hyperinsulinemia (P < 0.05) as well as both interventions combined (P < 0.001) induced an increase in laser Doppler flow, without capillary recruitment. Transcapillary leakage of sodium-fluorescein and sICAM-1 and vWF-Ag levels were unaffected by hyperglycemia or hyperinsulinemia. Microvascular permeability appears to be determined primarily by properties of the capillary wall and not by acute changes in local hemodynamics. The acute hyperglycemia- and hyperinsulinemia-induced vasodilatation is not accompanied by changes in microvascular permeability or endothelial markers.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0026-2862 1095-9319
DOI:	10.1006/mvre.2001.2347